Individual
JULIE SEVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
3350 W AMERICANA TER STE 210A, BOISE, ID 83706-2521
(208) 623-8530
(888) 604-8113
Mailing address
428 W FALL DR, BOISE, ID 83706-4822
(208) 965-7600
(888) 604-8113
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
5010
ID
101YM0800X
Mental Health Counselor
Primary
LCPC-6151
ID
Other
Enumeration date
08/11/2012
Last updated
05/05/2022
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