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Odyssey Mental Wellness PC

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Company Details

Name: Odyssey Mental Wellness PC
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Active-Good Standing
Date of registration: 23 Oct 2024 (8 months ago)
Financial Date End: 31 Oct 2025
Entity Number: 5949205
Place of Formation: IDAHO
File Number: 960817
ZIP code: 83402
County: Bonneville County
Mailing Address: 1350 ALAYSSA DR IDAHO FALLS, ID 83402-5066

Agent

Name Role Address
Mitchell Ray Barney Agent 1350 ALAYSSA DR, IDAHO FALLS, ID 83402

National Provider Identifier

NPI Number:
1023831468
Certification Date:
2024-11-04

Authorized Person:

Name:
MITCHELL BARNEY
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
1041C0700X - Clinical Social Worker
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Initial Filing 0005949205 2024-10-23

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Date of last update: 22 Jun 2025

Sources: Idaho Secretary of State