Organization · Type 2 NPI

Ponderosa Counseling and Wellness Practice, LLC

Professional Counselor · Boise, ID

NPI number 1063310175 Active

Practice location

6357 W Parapet Ct
Boise, ID 83703-2855

Call (208) 918-4603 Map

Mailing address

1015 Aoloa Pl Apt 302
Kailua, HI 96734-5204

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XNone listed
Professional Counselor Primary 101YP2500XNone listed

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About NPI 1063310175

Ponderosa Counseling and Wellness Practice, LLC's National Provider Identifier is 1063310175, issued on Oct 28, 2026. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Boise, ID. The record was last updated on Oct 28, 2026.