Provider Demographics
NPI:1477148062
Name:KOURI, CHARITY HELEN (LPC)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:HELEN
Last Name:KOURI
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 1:1546 BROOKSIDE LOOP
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3470
Mailing Address - Country:US
Mailing Address - Phone:720-768-4480
Mailing Address - Fax:
Practice Address - Street 1:1546 BROOKSIDE LOOP
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3470
Practice Address - Country:US
Practice Address - Phone:720-768-4480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0014747103TC1900X
CO103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling