KATELYN M BRADSHAW


Address: 7941 W Rifleman St, Boise, ID 83704-9001
Phone: 2088957950

KATELYN M BRADSHAW (NPI# 1114544541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114544541
Entity Type Individual
Full Name KATELYN M BRADSHAW
Practice Address 7941 W Rifleman St
Boise
ID 83704-9001
Mailing Address 1650 S Topaz Way
Meridian
ID 83642-4474
Practice Telephone 2088957950
Practice Fax Number 8552125682
Mailing Telephone 2086057070
Mailing Fax Number 2088983365
Enumeration Date 2020-07-01
Last Update Date 2020-08-18
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101Y00000X Counselor Behavioral Health & Social Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
847 Parkcentre Way Ste 7, Nampa, ID 836511794 2082296050 8552125682
10787 W Ustick Rd, Boise, ID 837135104 2086057070 8552125612

Office Location

Street Address 7941 W RIFLEMAN ST
City BOISE
State ID
Zip Code 83704-9001

Providers in the same location

NPI Name Taxonomy Address Enumeration
1043545106 Ashwood Recovery LLC. Clinic/Center 7941 W Rifleman St, Boise, ID 83704-9001 2009-10-07
1962017145 Dawn L Soriano Counselor 7941 W Rifleman St, Boise, ID 83704-9001 2020-09-14
1235754128 Casey Margaret Sullivan Social Worker 7941 W Rifleman St, Boise, ID 83704-9001 2020-06-16
1326663337 Adam Bryce Smith Counselor 7941 W Rifleman St, Boise, ID 83704-9001 2020-06-15
1184259970 Karen Riva Shein Counselor 7941 W Rifleman St, Boise, ID 83704-9001 2020-03-12
1942853197 Keith Deugan Counselor 7941 W Rifleman St, Boise, ID 83704-9001 2019-07-17
1538711866 Jessica Rudy Counselor 7941 W Rifleman St, Boise, ID 83704-9001 2019-07-16
1225699523 Robert James Dunfee Counselor 7941 W Rifleman St, Boise, ID 83704-9001 2019-06-26
1801452677 Ashwood Recovery LLC. Clinic/Center 7941 W Rifleman St, Boise, ID 83704-9001 2019-05-16
1578050076 Thomas J Childers-scott Social Worker 7941 W Rifleman St, Boise, ID 83704-9001 2018-04-19
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
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City BOISE
Zip Code 83704

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Dataset Information

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.

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