Provider Demographics
NPI:1811778673
Name:NORTH STAR COUNSELING, LLC
Entity type:Organization
Organization Name:NORTH STAR COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CROCKER-OSWALD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-392-0006
Mailing Address - Street 1:3350 W AMERICANA TER STE 100-B
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-2521
Mailing Address - Country:US
Mailing Address - Phone:208-392-0006
Mailing Address - Fax:
Practice Address - Street 1:3350 W AMERICANA TER STE 100-B
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-2521
Practice Address - Country:US
Practice Address - Phone:208-392-0006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty