Provider Demographics
NPI:1083112114
Name:PALIKHEL, JOAN (LPC)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:PALIKHEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 W AMBROSIA LN
Mailing Address - Street 2:
Mailing Address - City:KUNA
Mailing Address - State:ID
Mailing Address - Zip Code:83634-1634
Mailing Address - Country:US
Mailing Address - Phone:208-880-8713
Mailing Address - Fax:
Practice Address - Street 1:2500 W KOOTENAI ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-2408
Practice Address - Country:US
Practice Address - Phone:208-880-8713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-23
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
IDLPC-6659101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional