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

Ethan D Bonham

Individual provider Mental Health Counselor · NPI 1588596829

Ethan D Bonham is a Mental Health Counselor in Pocatello, Idaho. Licensed in Idaho. Registered with an NPI since 2026.

Licensed in
ID
In the registry since
2026

Practice location Address checks out

921 S 8th Ave
Pocatello, ID 83201-5377
Phone: (816) 977-7323
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 7481011 (ID)

Record details

NPI number1588596829
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 1, 2026
Last updated in NPPESJune 1, 2026
Certification dateJune 1, 2026
Mailing address921 S 8th Ave, Pocatello, ID 83201-5377

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