State of Mind Counseling and Wellness Center

NPI #1013277128 in Eagle, Idaho

Provider Information

NPI Number: 1013277128
Entity Type: Organization
Organization Name: State of Mind Counseling and Wellness Center
Primary Specialty: Clinic/Center - Adolescent and Children Mental Health
Enumeration Date: May 22, 2012
Last Updated: Jul 27, 2012

Practice Location

Address: 141 N PALMETTO AVE UNIT 1626
City: Eagle
State: Idaho
ZIP Code: 83616-8066
Phone: (208) 939-3999

Authorized Official

Name: LYNDA SMITH
Title: LPC
Phone: (208) 602-2293

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community/Behavioral Health	251S00000X
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X	Primary

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