MICHELE HICKMAN (NPI# 1255793659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255793659 |
Entity Type | Individual |
Full Name | MICHELE HICKMAN |
Credential | CPSS |
Practice Address |
1720 N Westgate Dr Boise ID 83704-7164 |
Practice Telephone | 2083340934 |
Mailing Telephone | 2083340934 |
Enumeration Date | 2016-03-24 |
Last Update Date | 2016-03-24 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 175T00000X | Peer Specialist | Other Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912253980 | Michele Elizabeth Hickman | Nurse Practitioner | 1935 Medical District Dr, Dallas, TX 75235-7701 | 2012-07-27 |
1184739708 | Michele E Hickman | Family Medicine | 615 Shipyard Blvd, Wilmington, NC 28412-6431 | 2006-08-21 |
Street Address |
1720 N WESTGATE DR |
City | BOISE |
State | ID |
Zip Code | 83704-7164 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245561505 | Jaime Rochelle Marshall | Community Health Worker | 1720 N Westgate Dr, Boise, ID 83704-7164 | 2010-01-26 |
1568026698 | Sarah Rosenbloom | Social Worker | 1720 N Westgate Dr, Boise, ID 83704-7164 | 2019-04-24 |
1093297228 | Eric John Leitzinger II | Student in an Organized Health Care Education/Training Program | 1720 N Westgate Dr, Boise, ID 83704-7164 | 2018-09-04 |
1275015703 | Cade Kirkhart | Counselor | 1720 N Westgate Dr, Boise, ID 83704-7164 | 2018-08-31 |
1124508619 | Amy Palmer | Developmental Therapist | 1720 N Westgate Dr, Boise, ID 83704-7164 | 2018-08-15 |
1427543958 | Monisha Oconnor | Counselor | 1720 N Westgate Dr, Boise, ID 83704 | 2018-06-27 |
1154830081 | Tyler Quinn Kerns | Student in an Organized Health Care Education/Training Program | 1720 N Westgate Dr, Boise, ID 83704-7164 | 2017-09-22 |
1033635990 | Jessica Anderson | Registered Nurse | 1720 N Westgate Dr, Boise, ID 83704-7164 | 2017-08-22 |
1043742943 | Melissa Ann Howard | Social Worker | 1720 N Westgate Dr, Suite A1, Boise, ID 83704-7164 | 2017-03-30 |
1265973788 | John Griffin | Registered Nurse | 1720 N Westgate Dr, Suire A-1, Boise, ID 83704-7164 | 2017-03-16 |
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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 Code | 175T00000X |
Grouping | Other Service Providers |
Classification | Peer Specialist |
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
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1790307890 | Jx2 LLC | Peer Specialist | 8950 W Emerald St Ste 178, Boise, ID 83704-8296 | 2020-05-12 |
1043860919 | Stephanie Coulter | Peer Specialist | 2200 W Fairview Ave, Boise, ID 83702-6808 | 2019-09-12 |
1538721014 | All Seasons Mental Health | Peer Specialist | 6933 W Emerald St, Boise, ID 83704-8616 | 2019-07-03 |
1881157949 | Lacey Megorden | Peer Specialist | 4222 W Emerald St, Boise, ID 83706-2037 | 2019-04-07 |
1235613688 | Devin R Pugmire | Peer Specialist | 300 S 23rd St, Boise, ID 83702-9100 | 2018-09-21 |
1255719092 | Matthew Caleb Weaver | Peer Specialist | 300 S 23rd St, Boise, ID 83702-9100 | 2015-05-13 |
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1639779523 | Tracie Lyn Hansen | Peer Specialist | 560 Fairway Dr, Pocatello, ID 83201-2012 | 2020-10-29 |
1609426923 | Amie Hughes | Peer Specialist | 4737 S Afton Pl Ste A, Chubbuck, ID 83202-2317 | 2019-09-18 |
1184113482 | Kolleen Marie Wynn-gallipeau | Peer Specialist | 444 Hospital Way Ste 447, Pocatello, ID 83201-2744 | 2018-05-02 |
1063034437 | Inroads, Inc | Peer Specialist | 3288 E Pine Ave, Meridian, ID 83642-5922 | 2020-05-08 |
1356962112 | Aaa American Healthcare LLC | Peer Specialist | 1301 E 17th St, Idaho Falls, ID 83404-6273 | 2020-05-04 |
1346878691 | Aspen Ministries Syringa Wellness | Peer Specialist | 1609 S Kimball Ave Ste 200, Caldwell, ID 83605-5196 | 2020-03-31 |
1962033399 | Lookout Behavioral Health LLC | Peer Specialist | 7905 N Meadowlark Way Ste A, Coeur D Alene, ID 83815-5041 | 2020-02-04 |
1356981419 | Lake City Counseling Center | Peer Specialist | 9705 N Shaw St, Hayden, ID 83835-9716 | 2020-01-07 |
1700425600 | Center Counseling, LLC | Peer Specialist | 265 E Chubbuck Rd, Chubbuck, ID 83202-5055 | 2019-12-26 |
1093351520 | Rawlings Community Counseling | Peer Specialist | 6807 Cody St, Bonners Ferry, ID 83805-8613 | 2019-11-19 |
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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.