MRS. MICHELLE MARIE BURKS (NPI# 1245500826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245500826 |
| Entity Type | Individual |
| Full Name | MRS. MICHELLE MARIE BURKS |
| Other Name | MRS. MICHELLE MARIE BURKS |
| Credential | CADC LPC |
| Practice Address |
1500 E Heritage Park St Ste 150 Meridian ID 83646-5800 |
| Practice Telephone | 0826310843 |
| Practice Fax Number | 2089060807 |
| Mailing Telephone | 0826310843 |
| Mailing Fax Number | 2089060807 |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2019-09-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LCPC6211 | ID | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 1245500826 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1674 W. Hill Rd., Suite 17, Boise, ID 83702 | 2088412641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487133617 | Michelle Antoinette Burks | Licensed Vocational Nurse | 120 N Walnut St, Jefferson, TX 75657-1934 | 2018-08-08 |
| Street Address |
1500 E HERITAGE PARK ST STE 150 |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83646-5800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447865373 | Ali Landers | Counselor | 1500 E Heritage Park St Ste 150, Meridian, ID 83646-5800 | 2020-09-08 |
| 1568070472 | Barbara May Saade | Counselor | 1500 E Heritage Park St Ste 150, Meridian, ID 83646-5800 | 2020-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982202743 | Jayson Paul Smith | Nurse Practitioner | 1545 East Leighfield Dr., Meridian, ID 83646 | 2020-10-14 |
| 1356977466 | Tanabell Health Services Inc | Assisted Living Facility | 2584 E Magic View Dr, Meridian, ID 83646 | 2020-03-20 |
| 1801351176 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 2656 E Magicview Dr, Meridian, ID 83646 | 2019-01-31 |
| 1306314323 | Cr Smiles - Meridian Dental Care LLC | Clinic/Center | 1500 W Cayuse Creek Dr, #100, Meridian, ID 83646 | 2018-11-07 |
| 1639644107 | Joseph Anomalay | Counselor | 6700 N. Linder Rd, Ste 156 #257, Meridian, ID 83646 | 2018-10-10 |
| 1275015950 | Mcmillan Family Dental Pllc | Clinic/Center | 1720 W. Mcmillan, Meridian, ID 83646 | 2018-08-30 |
| 1609327022 | Finding Home Healthcare, Inc. | Clinic/Center | 55 W Willowbrook Dr Ste 103, Meridian, ID 83646 | 2016-10-20 |
| 1952857161 | Mitchell Truong | Pharmacist | 622 E. Ustick Road, Caldwell, ID 83646 | 2016-08-28 |
| 1134511264 | Brittany Laub | Massage Therapist | 2572 N Stokesberry Pl #300, Meridian, ID 83646 | 2015-02-26 |
| 1194117366 | Westfall Ventures, Inc | Health Maintenance Organization | 2572 N. Stokesberry Pl, Meridian, ID 83646 | 2015-02-25 |
| Find all providers in zip 83646 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271843 | Krystle May Sears | Counselor | 1550 N Crestmont Dr Ste A, Meridian, ID 83642-2177 | 2020-10-01 |
| 1750927372 | Restoring Hope Healing From Trauma and Addiction LLC | Counselor | 850 E Franklin Rd Ste 405, Meridian, ID 83642-8917 | 2019-11-19 |
| 1942864434 | Carissa Ann Barnes | Counselor | 827 W Ashby Dr, Meridian, ID 83646-5695 | 2019-04-30 |
| 1134687809 | Lauren Yoder | Counselor | 3023 E Copper Point Dr Ste 108, Meridian, ID 83642-9290 | 2019-03-12 |
| 1376000943 | Amanda Marie Breneman | Counselor | 235 E Pine Ave, Meridian, ID 83642-2332 | 2019-03-01 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1740767623 | Serena Poland | Counselor | 3019 S Hudspeth Ave, Meridian, ID 83642-4815 | 2018-07-24 |
| 1821574294 | Anna Krzemieniecki | Counselor | 1406 N Main St Ste 203, Meridian, ID 83642-1746 | 2018-07-18 |
| 1972011062 | Ebone Shania Newton | Counselor | 2803 North Hills Street, Meridian, MS 35459 | 2018-01-11 |
| 1285143941 | Nicholas E O'brien | Counselor | 2463 E Gala St, Meridian, ID 83642 | 2017-09-26 |
| 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.