Second Wind Counseling, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LCPC-3442 Issued in ID

Legal business name

SECOND WIND COUNSELING, LLC

Practice address

1423 W Franklin St
Boise, ID 83702-5024

Phone

(208) 345-2212

Fax

(208) 345-2282

NPI assigned

Mar 8, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lonna Mahana

Title

Provider Relations

Phone

(208) 287-9420

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1043751175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7621 W WAVERLY DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837047210",
            "telephone_number": "208-287-9420",
            "fax_number": "208-287-9426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 W FRANKLIN ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025024",
            "telephone_number": "208-345-2212",
            "fax_number": "208-345-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND WIND COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-08",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "MAHANA",
        "authorized_official_first_name": "LONNA",
        "authorized_official_title_or_position": "PROVIDER RELATIONS",
        "authorized_official_telephone_number": "208-287-9420"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LCPC-3442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "LCPC-3442",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.