BROADER WELLNESS, LLC
NPI 1689480030
Clinic/Center - Mental Health (Including Community Mental Health Center) in Boise, ID

NPI Status: Active since December 09, 2024

Contact Information

3350 W AMERICANA TER STE 210A
BOISE, ID
ZIP 83706
Phone: (986) 279-3252
Fax: (208) 908-0034

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  • Organization
  • Clinic/Center
  • Mental Health (Including Community Menta...

About BROADER WELLNESS, LLC

This page provides the complete NPI Profile along with additional information for Broader Wellness, Llc, a provider established in Boise, Idaho operating as a Clinic/center, focusing in mental health (including community mental health center) . The healthcare provider is registered in the NPI registry with number 1689480030 assigned on December 2024. The practitioner's primary taxonomy code is 261QM0801X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Stacey Martinez Lcpc (Llc Member/manager)

NPI
1689480030
Provider Name
BROADER WELLNESS, LLC
Entity Type
Organization
Location Address
3350 W AMERICANA TER STE 210A BOISE, ID 83706
Location Phone
(986) 279-3252
Location Fax
(208) 908-0034
Mailing Address
PO BOX 6421 BOISE, ID 83707
Mailing Phone
(986) 279-3252
Mailing Fax
(208) 908-0034
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-09-2024
Last Update Date
12-09-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Mental Health (Including Community Mental Health Center)

Taxonomy Code
261QM0801X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

STACEY MARTINEZ LCPC

Authorized Official Title
LLC MEMBER/MANAGER
Authorized Official Phone
(986) 279-3252

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1689480030
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2616988006
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 1 + 6 + 9 + 8 + 8 + 0 + 0 + 6 + 24 = 70
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1689480030 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1659877785 KEVIN EARL L.M.T.
Individual
Massage Therapist3350 W AMERICANA TER STE 210A
BOISE, ID 83706
(208) 509-1811
1881941631 JULIE SEVERSON LCPC
Individual
Counselor (Mental Health)3350 W AMERICANA TER STE 210A
BOISE, ID 83706
(208) 623-8530
1407534449SOUL GOOD COUNSELING
Organization
Clinic/Center (Mental Health (Including Community Mental Health Center))3350 W AMERICANA TER STE 210A
BOISE, ID 83706
(208) 513-4791
1891401188 JESSICA AYERS LPC 9312
Individual
Counselor3350 W AMERICANA TER STE 210A
BOISE, ID 83706
(208) 513-4791
1619640265 STACEY ANN MARTINEZ LCPC
Individual
Counselor (Professional)3350 W AMERICANA TER STE 210A
BOISE, ID 83706
(986) 279-3252

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1689480030, enumerated in the NPI registry as an "organization" on December 09, 2024

The provider is located at 3350 W Americana Ter Ste 210a Boise, Id 83706 and the phone number is (986) 279-3252

This medical organization specializes in Clinic/Center with taxonomy code 261QM0801X with a focus in Mental Health (Including Community Mental Health Center)

This NPI record was last updated on December 09, 2024. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.