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

Lisa Michelle Koller, SUDA

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1467221093

Lisa Michelle Koller, SUDA is an Addiction (Substance Use Disorder) Counselor in Idaho Falls, Idaho. Practices as a sole proprietor. Licensed in Idaho.

Licensed in
ID
In the registry since
2023

Practice location Address checks out

1810 W Broadway St
Idaho Falls, ID 83402-5072
Phone: (208) 313-4550
Show map & directions

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

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 13020 (ID)

Record details

NPI number1467221093
Entity typeIndividual (Type 1)
GenderFemale
Credentials SUDA
Sole proprietorYes
NPI enumeratedDecember 22, 2023
Last updated in NPPESDecember 22, 2023
Certification dateDecember 22, 2023

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