Idaho Trauma Therapy LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

LPC-6772 Issued in ID

Legal business name

IDAHO TRAUMA THERAPY LLC

Practice address

6126 W State St Ste 109
Boise, ID 83703-2741

Phone

(208) 391-2957

NPI assigned

Jul 2, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Hillary Dawn Cook, LPCNPI 1497254783

Title

Owner

Phone

(208) 391-2957

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hillary Dawn Cook, LPC

  • Counselor
  • Boise, ID
  • NPI 1497254783
  NPD Authorized official

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530489600000",
    "number": "1477049492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6126 W STATE ST STE 109",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837032741",
            "telephone_number": "208-391-2957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6126 W STATE ST STE 109",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837032741",
            "telephone_number": "208-391-2957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO TRAUMA THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-02",
        "last_updated": "2018-07-02",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-391-2957",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "ID",
            "license": "LPC-6772",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "ID",
            "license": "LPC-6772",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "ID",
            "license": "LPC-6772",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Idaho State University
• Idaho Street Dental Inc
• Idaho Surgical Assistants PLLC
• Idaho TMS
• Idaho Transport LLC
• Idaho Virtual Academy
• Idaho Youth Ranch
• Idahome Caregivers
• Amy A Iddings, LCSW
• Ideal Health

• Mental Health Clinic/Center (Including Community Mental Health Center) in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.