Organization
GYST COUNSELING & WELLNESS LLC
Active
Organization
GYST COUNSELING & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK EDWARD WHITNEY LCSW (MEMBER)
(208) 473-1263
Entity
Organization
Contact information
Practice address
1002 BLAINE ST, SUITE 208, CALDWELL, ID 83605-5574
(208) 901-9159
Mailing address
11920 WEBSTER ST, CALDWELL, ID 83605-5506
(208) 473-1263
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
W112925
ID
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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