Organization
DALE WILSON COUNSELING AND EVALUATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE KEVIN WILSON LCSW (OWNER/SOCIAL WORKER)
(208) 713-9627
Entity
Organization
Contact information
Practice address
6126 W STATE ST STE 101, BOISE, ID 83703-2741
(208) 713-9627
Mailing address
6126 W STATE ST STE 101, BOISE, ID 83703-2741
(208) 713-9627
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
09/10/2020
Last updated
09/10/2020
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