Individual
MS. TRACI JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LCPC, NCC
Contact information
Practice address
500 W IDAHO ST STE 201, BOISE, ID 83702-5755
(208) 918-1593
Mailing address
500 W IDAHO ST STE 201, BOISE, ID 83702-5755
(208) 918-1593
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LCPC-7638
ID
101YM0800X
Mental Health Counselor
LCPC-7638
ID
101YP2500X
Professional Counselor
LCPC-7638
ID
Other
Enumeration date
07/13/2017
Last updated
07/21/2022
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