Individual
MANDY J LUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
550 2ND ST, SUITE 292, IDAHO FALLS, ID 83401-3900
(208) 529-2211
(208) 529-4647
Mailing address
550 2ND ST, P.O.BOX 1876, IDAHO FALLS, ID 83401-3900
(208) 529-2211
(208) 529-4647
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LSW24674
ID
1041C0700X
Clinical Social Worker
Primary
LCSW-40086
ID
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/20/2007
Last updated
02/11/2026
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