| Osprey Counseling | |
| 
					5503 W Kendall St Boise ID 83706-1240  | |
| (208) 912-7362 | |
| (208) 738-5858 | 
| Full Name | Osprey Counseling | 
|---|---|
| Speciality | Counselor | 
| Location | 5503 W Kendall St, Boise, Idaho | 
| Authorized Official Name and Position | Abigail Green (OFFICE MANAGER) | 
| Authorized Official Contact | 2089127362 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Osprey Counseling 1111 S Orchard St Ste 168 Boise ID 83705-1977 Ph: (208) 912-7362  | Osprey Counseling 5503 W Kendall St Boise ID 83706-1240 Ph: (208) 912-7362  | 
| NPI Number | 1427755420 | 
|---|---|
| Provider Enumeration Date | 02/09/2023 | 
| Last Update Date | 11/07/2023 | 
| Certification Date | 11/07/2023 | 
| Medicare PECOS PAC ID | 3173984192 | 
|---|---|
| Medicare Enrollment ID | O20230807001624 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1427755420 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary | 
| Provider Name | Brian H Green | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1922133719 PECOS PAC ID: 7416001813 Enrollment ID: I20090819000840  | 
| Provider Name | Mark Caldwell Smith | 
|---|---|
| Provider Type | Practitioner - Mental Health Counselor | 
| Provider Identifiers | NPI Number: 1770273534 PECOS PAC ID: 7618328881 Enrollment ID: I20240111004579  | 
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