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Idaho Mental Wellness Counseling, PLLC

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Company Details

Name: Idaho Mental Wellness Counseling, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 03 Apr 2023 (2 years ago)
Financial Date End: 30 Apr 2025
Entity Number: 5175835
Place of Formation: IDAHO
File Number: 872069
ZIP code: 83646
County: Ada County
Principal Address: 110 1510 W USTICK RD MERIDIAN, ID 83646
Mailing Address: JAMES ALLEN 5140 N ELMSTONE AVE MERIDIAN, ID 83646

Agent

Name Role Address
James R Allen Agent 5140 N ELMSTONE AVE, MERIDIAN, ID 83646

Member

Name Role Address Appointed On
Karen M Allen Member 3313 W. CHERRY LANE, PMB#221, MERIDIAN, ID 83642 2024-04-03

National Provider Identifier

NPI Number:
1629804703
Certification Date:
2024-09-13

Authorized Person:

Name:
KAREN ALLEN
Role:
CLINICIAN
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 0005666860 2024-04-03
Initial Filing 0005175835 2023-04-03

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Date of last update: 26 Mar 2025

Sources: Idaho Secretary of State