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North Idaho Counseling Center LLC

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Company Details

Name: North Idaho Counseling Center LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 09 Dec 2020 (5 years ago)
Financial Date End: 31 Dec 2025
Entity Number: 4096154
Place of Formation: IDAHO
File Number: 737084
ZIP code: 83835
County: Kootenai County
Principal Address: NICOLE NESTOR-GRAY 8596 WAYNE DRIVE HAYDEN, ID 83835
Mailing Address: NICOLE NESTOR-GRAY PO BOX 1061 ATHOL, ID 83801-1061

Agent

Name Role Address
Nicole Nestor-Gray Agent 8596 WAYNE DR, HAYDEN, ID 83835

Manager

Name Role Address Appointed On Resigned On
Gregory Gray Manager 8596 WAYNE DR, HAYDEN, ID 83835 2023-11-03 2023-11-03
Nicole Nestor-Gray Manager 8596 WAYNE DR, HAYDEN, ID 83835 2022-01-17 No data

National Provider Identifier

NPI Number:
1902495245
Certification Date:
2021-01-12

Authorized Person:

Name:
NICOLE NESTOR-GRAY
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0005968537 2024-11-06
Annual Report 0005459848 2023-11-03
Annual Report 0005017396 2022-12-07
Annual Report 0004573390 2022-01-17
Initial Filing 0004096154 2020-12-09

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Date of last update: 08 Jul 2025

Sources: Idaho Secretary of State