LISA M BROKAW (NPI# 1104305515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104305515 |
| Entity Type | Individual |
| Full Name | LISA M BROKAW |
| Credential | LPC, NCC |
| Practice Address |
2176 E Franklin Rd Ste 100 Meridian ID 83642-8009 |
| Mailing Address |
477 N Stear Ave Kuna ID 83634-5004 |
| Practice Telephone | 2085157661 |
| Mailing Telephone | 2085700503 |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2018-08-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LPC-6942 | ID | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851352652 | Lisa Brokaw | Nurse Anesthetist, Certified Registered | 2600 Sixth St Sw, Ohio Hospital Based Physician Corp, Canton, OH 44710 | 2006-03-31 |
| Street Address |
2176 E FRANKLIN RD STE 100 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-8009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285767913 | Heather Sue Tustison | Counselor | 2176 E Franklin Rd Ste 100, Meridian, ID 83642-8009 | 2007-03-13 |
| 1366058364 | Melissa M Cory Counseling LLC | Counselor | 2176 E Franklin Rd Ste 100, Meridian, ID 83642-8009 | 2020-09-16 |
| 1821603911 | Melissa Cory | Counselor | 2176 E Franklin Rd Ste 100, Meridian, ID 83642-8009 | 2020-09-15 |
| 1760008981 | Jennifer Marie De Prima | Counselor | 2176 E Franklin Rd Ste 100, Meridian, ID 83642-8009 | 2020-06-23 |
| 1043873144 | Janice Edwards | Counselor | 2176 E Franklin Rd Ste 100, Meridian, ID 83642-8009 | 2019-04-15 |
| 1881157766 | Meghan J Brewer | Counselor | 2176 E Franklin Rd Ste 100, Meridian, ID 83642-8009 | 2019-04-09 |
| 1861966574 | Treasure Wellness, Pllc | Counselor | 2176 E Franklin Rd Ste 100, Meridian, ID 83642-8009 | 2019-01-15 |
| 1568970515 | Gina Michelle Sewell | Counselor | 2176 E Franklin Rd Ste 100, Meridian, ID 83642-8009 | 2018-01-11 |
| 1346652401 | Robert Mcintyre | Counselor | 2176 E Franklin Rd Ste 100, Meridian, ID 83642-8009 | 2014-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881208056 | Cameron Cushing | Counselor | 3293 E Plympton Dr, Meridian, ID 83642-9019 | 2020-09-03 |
| 1982260329 | Maxwell Aristaeus Dusky | Counselor | 3017 S Meridian Rd, Meridian, ID 83642-7962 | 2019-05-10 |
| 1376915298 | Donna Eldridge | Counselor | 3507 Causeyville Rd, Meridian, MS 39301-9174 | 2015-10-30 |
| 1245601616 | Lindsay Kyle | Counselor | 1316 Ridgeview Cir, Meridian, MS 39305-2743 | 2015-10-12 |
| 1952790297 | Wendy Fisher | Counselor | 744 W Kingsley St, Meridian, ID 83646-6222 | 2015-01-09 |
| 1326443938 | Ophelia Mayfield | Counselor | 1923 23rd Ave., Meridian, MS 39301 | 2014-10-24 |
| 1114355757 | Gail Ingra Peterson | Counselor | 3043 S Meridian Rd, Suite 125, Meridian, ID 83642-7922 | 2013-10-16 |
| 1558795773 | Jami Clevenger | Counselor | 943 W Overland Rd Ste 157, Meridian, ID 83642-6541 | 2013-08-23 |
| 1871927152 | Michele Ann Gallegos | Counselor | 2704 N Caribou Way, Meridian, ID 83646-3475 | 2013-08-22 |
| 1184965741 | Juakita L. Grice | Counselor | 1415 35th Ave, Meridian, MS 39301-3628 | 2013-03-07 |
| Find all providers in MERIDIAN | ||||
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| 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.