Provider Demographics
NPI:1972141265
Name:CALM WATERS COUNSELING PLLC
Entity Type:Organization
Organization Name:CALM WATERS COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, EMDR-T, RS
Authorized Official - Phone:208-371-7226
Mailing Address - Street 1:10108 W OVERLAND RD # A
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-1428
Mailing Address - Country:US
Mailing Address - Phone:208-371-7226
Mailing Address - Fax:208-375-7251
Practice Address - Street 1:10108 W OVERLAND RD # A
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-1428
Practice Address - Country:US
Practice Address - Phone:208-371-7226
Practice Address - Fax:208-375-7251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty