Provider Demographics
NPI:1336734060
Name:VIGILANT COUNSELING
Entity Type:Organization
Organization Name:VIGILANT COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VIGILANT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:601-207-2103
Mailing Address - Street 1:671 E RIVERPARK LN STE 120
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-4000
Mailing Address - Country:US
Mailing Address - Phone:601-207-2103
Mailing Address - Fax:208-379-2181
Practice Address - Street 1:671 E RIVERPARK LN STE 120
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-4000
Practice Address - Country:US
Practice Address - Phone:601-207-2103
Practice Address - Fax:208-379-2181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty