Provider Demographics
NPI:1952711996
Name:KUNA COUNSELING CENTER
Entity Type:Organization
Organization Name:KUNA COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT LCPC
Authorized Official - Phone:208-750-3000
Mailing Address - Street 1:PO BOX 959
Mailing Address - Street 2:
Mailing Address - City:KUNA
Mailing Address - State:ID
Mailing Address - Zip Code:83634-0900
Mailing Address - Country:US
Mailing Address - Phone:208-750-3000
Mailing Address - Fax:
Practice Address - Street 1:504 MAIN ST STE 444
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-1869
Practice Address - Country:US
Practice Address - Phone:208-750-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-2908251S00000X
WALF- 60140407251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health