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Lost River Counseling PLLC

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Company Details

Name: Lost River Counseling PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 12 Jun 2023 (2 years ago)
Financial Date End: 30 Jun 2025
Entity Number: 5276045
Place of Formation: IDAHO
File Number: 883621
ZIP code: 83402
County: Bonneville County
Principal Address: DANIEL GRIFFIN SUITE 258 1075 RIVERWALK DRIVE IDAHO FALLS, ID 83402
Mailing Address: DANIEL GRIFFIN STE 264 1070 RIVERWALK DR IDAHO FALLS, ID 83402

Agent

Name Role Address
Daniel J Griffin Agent 1070 RIVERWALK DRIVE, 264, DANIEL GRIFFIN, IDAHO FALLS, ID 83402

Manager

Name Role Address Appointed On
SHAELYN DANA GRIFFIN Manager 113 E 14TH ST, IDAHO FALLS, ID 83404 2024-07-07

National Provider Identifier

NPI Number:
1750157400
Certification Date:
2024-06-07

Authorized Person:

Name:
DANIEL JAMES GRIFFIN
Role:
OWNER/THERAPIST
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
Change of Registered Office/Agent/Both (by Entity) 0005829946 2024-07-26
Annual Report 0005809326 2024-07-07
Statement of Change of Business Mailing Address 0005366891 2023-08-18
Initial Filing 0005276045 2023-06-12

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Date of last update: 20 Jun 2025

Sources: Idaho Secretary of State