MS. LYDIA JO MISSAL (NPI# 1083959332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083959332 |
| Entity Type | Individual |
| Full Name | MS. LYDIA JO MISSAL |
| Credential | LCPC |
| Practice Address |
1832 E. 1750 S. Gooding ID 83330 |
| Mailing Address |
Po Box 5895 Hailey ID 83333-5895 |
| Practice Telephone | 2089344444 |
| Practice Fax Number | 2089345171 |
| Mailing Telephone | 4065462025 |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2016-09-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
LPC-5912 | ID | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
LCPC-5876 | ID | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
2407 | MT | Behavioral Health & Social Service Providers |
| Street Address |
1832 E. 1750 S. |
| City | GOODING |
| State | ID |
| Zip Code | 83330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346648227 | Erin Orloff | Speech-Language Pathologist | 202 14th St Ave E, Gooding, ID 83330 | 2014-12-09 |
| 1518377019 | North Canyon Medical Center, Inc. | Clinic/Center | 267 N. Canyon Drive, Gooding, ID 83330 | 2014-05-06 |
| 1013240910 | Marcella Louise Heil | Speech-Language Pathologist | 1735 South 1800 East, Gooding, ID 83330 | 2009-09-09 |
| 1861561094 | Thomas Ernest Pryor | Family Medicine | 121 5th Ave West, Gooding, ID 83330 | 2006-11-06 |
| 1942212600 | Marcy Lin Morrow | Physician Assistant | 134 4th Ave W, Gooding Family Physicians, Gooding, ID 83330 | 2006-08-12 |
| 1174535835 | Ian B Kunz | Physician Assistant | 267 N Canyon Drive, Gooding, ID 83330 | 2006-08-12 |
| 1326002650 | Associates In Family Practice Pa | Family Medicine | 425 Idaho St, Gooding, ID 83330 | 2006-04-13 |
| 1497719728 | Mark D Spencer | Family Medicine | 425 Idaho Street, Gooding, ID 83330 | 2006-04-13 |
| 1871115717 | Megan George | Counselor | 1832 E 1750 S, Gooding, ID 83330 | 2020-05-14 |
| 1982173746 | Tdc Gooding Pllc | Dentist | 325 Main Street, Gooding, ID 83330 | 2018-11-21 |
| Find all providers in zip 83330 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871115717 | Megan George | Counselor | 1832 E 1750 S, Gooding, ID 83330 | 2020-05-14 |
| 1033754551 | Taylor Anne Van Holland | Counselor | 605 11th Ave E, Gooding, ID 83330-5368 | 2019-11-07 |
| 1346503877 | Denise Marie Jensen | Counselor | 215 University Dr, Gooding, ID 83330-6155 | 2012-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648015 | Abigail Oakley | Counselor | Tueller Counseling Services, 2275 W Broadway Suite G, Idaho Falls, ID 83402 | 2020-10-30 |
| 1679172472 | Dynisha Smith | Counselor | 9277 W Shoup Ave, Boise, ID 83709-0557 | 2020-10-22 |
| 1710592142 | Bruce F. Pagano II | Counselor | 1217 3rd St S Ste 103, Nampa, ID 83651-3917 | 2020-09-11 |
| 1881208056 | Cameron Cushing | Counselor | 3293 E Plympton Dr, Meridian, ID 83642-9019 | 2020-09-03 |
| 1689285892 | Jacob Santhouse | Counselor | 824 17th Ave S Ste 7, Nampa, ID 83651-4781 | 2020-08-11 |
| 1487264032 | Esteem Counseling, LLC | Counselor | 1404 North Marcasite Court, Post Falls, ID 83854 | 2020-08-07 |
| 1669081311 | Catherine Leavitt | Counselor | 921 S 8th Ave # 8136, Pocatello, ID 83209-0002 | 2020-07-29 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1013535145 | Revitalize Consulting Group, Inc. | Counselor | 202 S Midland Blvd, Nampa, ID 83686-2602 | 2020-07-06 |
| 1427670314 | Richard Meyers | Counselor | 2052 Jennie Lee Dr Ste 2, Idaho Falls, ID 83404-7056 | 2020-05-13 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MS. LYDIA JO MISSAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.