Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Modern Psychotherapy Services

Organization Professional Counselor · NPI 1649674888

Modern Psychotherapy Services is a Professional Counselor in Eagle, Idaho. Licensed in Idaho. Registered with an NPI since 2014.

Licensed in
ID
In the registry since
2014

Practice location Address checks out

4875 W Athens Ct
Eagle, ID 83616-5138
Phone: (208) 731-7646
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LPC-5605 (ID)

Record details

NPI number1649674888
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diana Lincoln-Haye — President · (208) 731-7646
NPI enumeratedOctober 17, 2014
Last updated in NPPESOctober 17, 2014
Mailing address4875 W Athens Ct, Eagle, ID 83616-5138

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