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TRACI CRABB, PSY.D., PLLC

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Company Details

Name: TRACI CRABB, PSY.D., PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 22 Jun 2006 (19 years ago)
Financial Date End: 30 Jun 2026
Entity Number: 167523
Place of Formation: IDAHO
File Number: 167523
ZIP code: 83646
County: Ada County
Principal Address: 2584 N STOKESBERRY PL MERIDIAN, ID 83646
Mailing Address: STE 160 5418 N EAGLE RD BOISE, ID 83713-0100

Agent

Name Role Address
TRACI CRABB Agent 5418 N EAGLE RD, SUITE 160, BOISE, ID 83713

Manager

Name Role Address Appointed On Resigned On
Traci L Crabb Manager 2584 N STOKESBERRY PL., MERIDIAN, ID 83646 2021-05-05 2024-05-03
Traci Crabb Manager 5418 N EAGLE RD, BOISE, ID 83713 2024-05-03 No data

National Provider Identifier

NPI Number:
1699015511

Authorized Person:

Name:
TRACI CRABB
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
Yes

Contacts:

Fax:
2089381399

Filing

Filing Name Filing Number Filing date
Annual Report 0006256841 2025-05-15
Annual Report 0005717787 2024-05-03
Statement of Change of Business Mailing Address 0005502555 2023-12-06
Annual Report 0005225355 2023-05-05
Annual Report 0004776940 2022-06-09

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Date of last update: 25 Jun 2025

Sources: Idaho Secretary of State