Individual
ELISABETH PEDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
545 N BENJAMIN LN, BOISE, ID 83704-9623
(208) 322-1026
Mailing address
1520 S WHIPOORWILL WAY, BOISE, ID 83709-1369
(208) 863-8549
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
09/26/2022
Last updated
10/27/2025
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