Banyan Tree Wellness, PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BANYAN TREE WELLNESS, PLLC

Practice address

410 S Orchard St Ste 124
Boise, ID 83705-1210

Phone

(208) 398-0826

NPI assigned

Jun 11, 2020

Organization subpart

No

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

Authorized official

Name

Billylynn Pestell, LCSW

Title

Therapist/Owner

Phone

(208) 398-0826

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1164047460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 S ORCHARD ST STE 124",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051210",
            "telephone_number": "208-398-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S ORCHARD ST STE 124",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051210",
            "telephone_number": "208-398-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANYAN TREE WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-11",
        "last_updated": "2024-06-05",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "PESTELL",
        "authorized_official_first_name": "BILLYLYNN",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "208-398-0826",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497318802",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Bangs, MD
• Jeffrey Steven Bank, M.D.
• Kelly Rachel Bankard, LMSW
• Ianitza Bankova, PHARMD
• Courtney Hobza Bannick, MD
• Keenan Baptista, DO
• Mark Edward Baradziej, M.D.
• Jacqueline Barajas, PA-C
• Kenneth G Baranco, D.D.S.
• Aleksandra Baranova, LMT

• Community/Behavioral Health Agency in Boise, ID
• Providers in Boise, ID by specialty
• Community/Behavioral Health Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.