Provider Demographics
NPI:1245039171
Name:BODHICITTA COUNSELING IOP
Entity type:Organization
Organization Name:BODHICITTA COUNSELING IOP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPPERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-929-6845
Mailing Address - Street 1:250 NORTHWEST BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2971
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:250 NORTHWEST BLVD STE 110
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2971
Practice Address - Country:US
Practice Address - Phone:208-929-6845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BODHICITTA COUNSELING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health