Organization Active NPI

Golden Mountain Wellness LLC

  • Clinical Social Worker
  • Fruitland, ID
National Provider Identifier
1649134347
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
GOLDEN MOUNTAIN WELLNESS LLC
Practice address
425 S Whitley Dr Ste 200
Fruitland, ID 83619-2611
Phone
(208) 230-7452
Fax
(208) 230-7452
NPI assigned
Dec 16, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Authorized official

Name
Paige Bunker, LCSW
Title
Owner
Phone
(208) 230-7452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

425 S Whitley Dr Ste 200
Fruitland, ID 83619-2611

Mailing address

425 S Whitley Dr Ste 200
Fruitland, ID 83619-2611
Phone (208) 230-7452

National Provider Directory

National Provider Directory

Locations

425 S Whitley Dr
Ste 200
Fruitland, ID 83619
Phone (208) 230-7452

NPI Registry JSON

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

{
    "created_epoch": "1765843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1649134347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 S WHITLEY DR STE 200",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192611",
            "telephone_number": "208-230-7452",
            "fax_number": "208-230-7452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S WHITLEY DR STE 200",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192611",
            "telephone_number": "208-230-7452",
            "fax_number": "208-230-7452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN MOUNTAIN WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-16",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "BUNKER",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-230-7452",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fruitland, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.