Provider Demographics
NPI:1508018086
Name:LANZET, STEVEN I (MED)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:I
Last Name:LANZET
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W KOOTENAI ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-2408
Mailing Address - Country:US
Mailing Address - Phone:208-908-0500
Mailing Address - Fax:208-908-0580
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:208-908-0500
Practice Address - Fax:208-908-0580
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC 243101YP2500X
IDLMFT 2634106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional