Individual provider · Type 1 NPI

Bevin Jay Modrak, LCPC

Mental Health Counselor · Boise, ID

NPI number 1326316514 Active

Practice location

204 S Cole Rd
Boise, ID 83709-0934

Call (208) 319-9786 Map

Fax (208) 319-7773

Mailing address

6568 S Federal Way, #124
Boise, ID 83716-9277

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XLCPC4698 (ID)

Mental Health Counselor: Definition to come...

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About NPI 1326316514

Bevin Jay Modrak, LCPC's National Provider Identifier is 1326316514, issued on Dec 2, 2011. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Boise, ID. The record was last updated on Mar 29, 2023.