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Phil Waggoner

Counselor·Lewiston, ID· NPI 1871651422 · Enumerated 2006 · 19 years on NPI
Phil Waggoner is 1 of 266 counselor organizations in Idaho.
NPI age
19 years
Enumerated 2006-12-05
Primary specialty
Counselor
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Boyd
Business Ofc Manager Owner
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05

How this organization compares

Across 266 active counselor providers in Idaho.

NPI age
19 years
↑ 10 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0

NPI lifetime · 2006 → 2026

2006-12Enumerated in NPPES
2006 2026

Where they practice

Primary practice location
1720 18th Ave
Lewiston, ID 835014047
📞 2087464097fax 2087462294
Mailing address
1720 18th Ave
Lewiston, ID 83501
📞 2087464097fax 2087462294

Authorized official

Dana K Boyd
Business Ofc Manager Owner
📞 2087464097

Individual providers at this organization

17 individual providers on file at this primary practice address.

Specialties

Behavioral Health & Social Service Providers › Counselor
  • Counselor Primary
    Definition to come...
    ID license #138 taxonomy 101YA0400X

Other names on file (1)

Doing-business-as, former, and alternate names recorded by NPPES.

  • Riverside Recovery
    Type code 3 recorded 2006-12-05

Practice context

Multi-provider organization. 17 individual providers on file at this primary address.

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How to verify this organization

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

Related

Counselor organizations in Idaho
→ Idaho hub
About this specialty
→ Specialty guide