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Organization

UTOPIA COUNSELLING AND ADOPTION SERVICES, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ELIZABETH A JACKSON LCSW (OWNER/COUNSELLOR)
(208) 794-9588
Entity
Organization

Contact information

Practice address
1111 S ORCHARD ST STE 100, BOISE, ID 83705-1961
(208) 794-9588
Mailing address
1111 S ORCHARD ST STE 100, BOISE, ID 83705-1961
(208) 794-9588

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
33837
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1649694233
ID
01
20008188
MEDICARE
ID
Enumeration date
11/09/2017
Last updated
03/07/2024
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