Provider Demographics
NPI:1386778959
Name:SEQUOIA COUNSELING SERVICES, INC.
Entity type:Organization
Organization Name:SEQUOIA COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:208-798-1646
Mailing Address - Street 1:PO BOX 1895
Mailing Address - Street 2:531 BRYDEN AVE
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-1463
Mailing Address - Country:US
Mailing Address - Phone:208-798-1646
Mailing Address - Fax:208-798-5568
Practice Address - Street 1:531 BRYDEN AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-4438
Practice Address - Country:US
Practice Address - Phone:208-798-1646
Practice Address - Fax:208-798-5568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2025-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID806555100Medicaid