person
Mr. Lyle Spencer Bourcy, LCPC
Professional Counselor in Fruitland, Idaho
NPI 1235130162

Lyle Spencer Bourcy is a Professional Counselor based in Fruitland, ID and is specialized in Professional. Lyle Spencer Bourcy practices in Fruitland, ID and has the professional credentials of LCPC. The NPI Number for Lyle Spencer Bourcy is 1235130162 and holds a License No. LCPC-2757 (Idaho).

The current practice location address for Lyle Spencer Bourcy is 1303 Nw 16Th St, Fruitland, ID and can be reached out via phone at 208-250-0374 and via fax at 208-452-2164.

Location: 1303 Nw 16Th St, Fruitland, ID, 83619-2263
person
Provider Profile Details
NPI Number
1235130162
Provider Name
Lyle Spencer Bourcy
Credential
LCPC
Provider Entity Type
Individual
Gender
Male
Address
1303 Nw 16Th St, Fruitland, ID, 83619-2263
Phone Number
208-250-0374
Fax Number
208-452-2164
Provider Enumeration Date
08/02/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
Q3543 01 ID BLUE CROSS OF IDAHO PROVI
0000101364 01 ID BLUE SHIELD OF IDAHO
institution
Provider Business Practice Location Address Details
Address
1303 Nw 16Th St
City
State
Zip
83619-2263
Phone Number
208-250-0374
Fax Number
208-452-2164
person
Provider Business Mailing Address Details
Address
1303 Nw 16Th St
City
State
Zip
83619-2263
Phone Number
208-250-0374
Fax Number
208-452-2164
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
LCPC-2757 (Idaho)
Definition
Definition to come...
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