SALLY MCCOLLUM (NPI# 1609984210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609984210 |
| Entity Type | Individual |
| Full Name | SALLY MCCOLLUM |
| Credential | PHD |
| Practice Address |
171 W. 1st St #1 Ketchum ID 83340-6078 |
| Mailing Address |
Po Box 6078 Ketchum ID 83340-6078 |
| Practice Telephone | 2087268926 |
| Practice Fax Number | 2087268926 |
| Mailing Telephone | 2087268926 |
| Mailing Fax Number | 2087268926 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2015-01-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY 237 | ID | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356732671 | Sally Mccollum | Pharmacist | Duke University Health Systems, Dumc 3089, Erwin Road, Durham, NC 27710-0001 | 2015-02-09 |
| Street Address |
171 W. 1ST ST #1 |
| City | KETCHUM |
| State | ID |
| Zip Code | 83340-6078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779606 | Rooted Womens Health | Occupational Therapist | 431 N Walnut Ave, Ketchum, ID 83340 | 2020-10-29 |
| 1841826252 | Pilar Settlemier Tumolo | Counselor | 220 River Street East, Ketchum, ID 83340 | 2020-03-17 |
| 1598390643 | Alyson Holmes Witmer | Counselor | 220 2nd Ave, Ste 201, Ketchum, ID 83340 | 2020-03-10 |
| 1952864506 | Mollie Parker Szybala | Naturopath | 128 Saddle Rd, Suite 103-c, Ketchum, ID 83340 | 2019-04-10 |
| 1740789353 | Courtney Loving | Counselor | 208 N. Spruce, Ketchum, ID 83340 | 2018-02-09 |
| 1164876785 | Rebecca Grace | Psychologist | 200 River St East, Ketchum, ID 83340 | 2016-04-20 |
| 1306209556 | Garrett Coman | Dermatology | St. Luke's Dermatology, 191 5th Street West, Ketchum, ID 83340 | 2016-04-04 |
| 1265895775 | Innerhealth Md PC | Acupuncturist | 180 West 1st Street, Suite 206, Ketchum, ID 83340 | 2016-04-01 |
| 1487023503 | Tomomi Ikawa | Chiropractor | 131 4th St. E., Suite 310, Ketchum, ID 83340 | 2015-09-18 |
| 1790195766 | Maria Morris | Acupuncturist | 220 South 2nd Ave #101, Ketchum, ID 83340 | 2014-04-30 |
| Find all providers in zip 83340 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164876785 | Rebecca Grace | Psychologist | 200 River St East, Ketchum, ID 83340 | 2016-04-20 |
| 1902146186 | Joann Sorento | Psychologist | 323 Lewis St., Ketchum, ID 83340 | 2013-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376164723 | Krystal Anne Wood | Psychologist | 605 E Holly St Apt 206, Boise, ID 83712-7882 | 2020-04-27 |
| 1457993230 | Morgan Mental Health Group LLC | Psychologist | 4600 W Quarterhorse Ln, Meridian, ID 83642-5438 | 2019-10-12 |
| 1346890175 | Robert D Rieske | Psychologist | 921 S 8th Ave Stop 8112, Pocatello, ID 83209-8112 | 2019-09-13 |
| 1366953788 | Timothy L Bowers | Psychologist | 999 S Clear Lake Pl, Eagle, ID 83616-6179 | 2017-10-12 |
| 1528595329 | Richard D Craig | Psychologist | 2178 W Windchime Dr, Meridian, ID 83646-3535 | 2017-05-11 |
| 1467994616 | Heather Eskridge Hoyt Phd LLC | Psychologist | 671 E Riverpark Lane Ste 220, Boise, ID 83706-6559 | 2016-11-04 |
| 1144771338 | Heather E Hoyt | Psychologist | 671 E Riverpark Ln, Suite 220, Boise, ID 83706-6559 | 2016-10-22 |
| 1407276850 | Kyla Mcburney-rebol | Psychologist | 550 W. Sunnyside, Suite 1, Idaho Falls, ID 83402 | 2014-04-24 |
| 1659793867 | Kenneth Locke | Psychologist | 121 W Sweet Ave, University of Idaho - Child & Youth Study Center, Moscow, ID 83844-4061 | 2014-01-08 |
| 1194075994 | Daniel Glen Gibson | Psychologist | 850 E Franklin Rd Ste 404, Meridian, ID 83642 | 2012-09-19 |
| Find all providers with the same taxonomy | ||||
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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.