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SHADOW AND LIGHT WELLNESS LLC
NPI 1023823531
Counselor - Mental Health in Ammon, ID

Active since February 11, 2025

NPPES record last updated: February 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shadow And Light Wellness Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHADOW AND LIGHT WELLNESS LLC (NPI 1023823531) is a healthcare organization registered as a mental health in Ammon, Idaho and active in the NPI registry since February 2025. The organization lists Samantha Darlene Hodge-tracy, Owner/counselor, as its authorized official.

NPPES Registry Identity

NPI1023823531
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameSHADOW AND LIGHT WELLNESS LLC
Location Address919 S 25TH EAmmon, ID 83406-5731
Mailing Address785 Terrace DrIdaho Falls, ID 83402-3113 · (208) 227-3571
Phone(208) 227-3571
Organization SubpartNo
Authorized OfficialSamantha Darlene Hodge-tracyOwner/counselor · (208) 227-3571
Enumeration DateFebruary 11, 2025
NPPES CertifiedFebruary 11, 2025
✔ NPI 1023823531 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
919 S 25TH E, Ammon, ID 83406
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELITE HEALTH CARE
In Home Supportive Care
919 S 25TH E
AMMON, ID 83406
Bonneville County (208) 821-8432

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shadow And Light Wellness LLC's NPI number?

The NPI number for Shadow And Light Wellness LLC is 1023823531. It was assigned to this organization in the NPPES registry on February 11, 2025.

Where is Shadow And Light Wellness LLC located?

Shadow And Light Wellness LLC is located at 919 S 25th E, Ammon, ID 83406. The listed phone number is (208) 227-3571.

What is Shadow And Light Wellness LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Shadow And Light Wellness LLC was last updated on February 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.