| Organization Name: | BOURNER COUNSELING SERVICES |
| NPI Number: | 1346644788 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MEGAN BOURNER (OWNER) |
| Mailing Address: | 100 S Iowa Ave Fruitland |
| State: | ID US |
| Postal Code: | 836192644 |
| Phone Number: | 2084534378 |
| Fax Number: | 2084524378 |
| NPI Enumeration Date: | 10/14/2014 |
| NPI Last Update Date: | 10/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPC5147 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |