Provider Demographics
NPI:1659944353
Name:HEART AND MIND COUNSELING PLLC
Entity Type:Organization
Organization Name:HEART AND MIND COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROOT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-918-8700
Mailing Address - Street 1:115 N LOUISA ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-8234
Mailing Address - Country:US
Mailing Address - Phone:208-918-8700
Mailing Address - Fax:
Practice Address - Street 1:413 N ALLUMBAUGH ST STE 102
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-9219
Practice Address - Country:US
Practice Address - Phone:208-918-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-20
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty