MR. CHARLES BENTON MCCONNELL (NPI# 1104932383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104932383 |
| Entity Type | Individual |
| Full Name | MR. CHARLES BENTON MCCONNELL |
| Credential | MA |
| Practice Address |
413 N Allumbaugh Suite 103 Boise ID 83704 |
| Practice Telephone | 2086580800 |
| Practice Fax Number | 2083231894 |
| Mailing Telephone | 2086580800 |
| Mailing Fax Number | 2083231894 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | LPCP 127 | ID | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760693246 | Charles Michael Mcconnell | Dentist | 15 Fee Fee Rd, Maryland Heights, MO 63043-2728 | 2007-05-25 |
| 1073514014 | Charles T Mcconnell | Radiology | 375 Dixmyth Ave, Cincinnati, OH 45220-2475 | 2005-08-01 |
| Street Address |
413 N ALLUMBAUGH SUITE 103 |
| City | BOISE |
| State | ID |
| Zip Code | 83704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467556688 | Janet G Graf | Nurse Practitioner | 413 N Allumbaugh, Suite 103, Boise, ID 83704 | 2006-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457975781 | Nikhail Sinea Maestas | Counselor | 3649 N Lakeharbor Ln, Boise, ID 83703-6913 | 2020-06-02 |
| 1750930277 | Julie Anne Meza | Counselor | 8691 W Mediterranean Ct, Boise, ID 83709-2600 | 2019-09-06 |
| 1396203212 | Ofelia Z Andrews | Counselor | 930 N Maple Grove Rd Apt D302, Boise, ID 83704-8284 | 2019-03-10 |
| 1497254783 | Hillary Dawn Cook | Counselor | 6126 W State St # 202, Boise, ID 83703-2741 | 2018-02-02 |
| 1730602962 | Alyssa Peters | Counselor | 1655 W Fairview Ave Ste 115, Boise, ID 83702-5173 | 2017-07-19 |
| 1942722707 | Traci Johnston | Counselor | 500 W Idaho St Ste 201, Boise, ID 83702-5755 | 2017-07-13 |
| 1043751431 | Robert Deines | Counselor | 11960 W Bowmont St, Boise, ID 83713-6601 | 2017-03-17 |
| 1407209497 | Katey Stroud Clark | Counselor | 2995 N Cole Rd Ste 225, Boise, ID 83704-5966 | 2016-07-14 |
| 1962851444 | Tobin Chambers Baldwin | Counselor | 3350 W Americana Ter Ste 210b, Boise, ID 83706-2521 | 2016-06-06 |
| 1215398524 | Brandi Bechtel | Counselor | 3003 N Overlook Rd, Apt 26, Boise, ID 83704-6278 | 2016-03-14 |
| Find all providers in BOISE | ||||
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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.