Provider Demographics
NPI:1043007412
Name:CLOSE THE GAP LLC
Entity type:Organization
Organization Name:CLOSE THE GAP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:JACQUELINE
Authorized Official - Last Name:SHEDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, NCC
Authorized Official - Phone:208-918-0953
Mailing Address - Street 1:750 E WARM SPRINGS AVE STE F
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6457
Mailing Address - Country:US
Mailing Address - Phone:208-918-0953
Mailing Address - Fax:
Practice Address - Street 1:750 E WARM SPRINGS AVE STE F
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-6457
Practice Address - Country:US
Practice Address - Phone:208-918-0953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-21
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty