Provider Demographics
NPI:1699650853
Name:JEWELL, MADELEINE (MCOUN, LPC, NCC)
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:
Last Name:JEWELL
Suffix:
Gender:X
Credentials:MCOUN, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 S ORCHARD ST STE 184
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-1293
Mailing Address - Country:US
Mailing Address - Phone:208-994-5604
Mailing Address - Fax:
Practice Address - Street 1:410 S ORCHARD ST STE 184
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-1293
Practice Address - Country:US
Practice Address - Phone:208-214-7408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID2571567101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor