BRET V WIXOM (NPI# 1720171358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720171358 |
| Entity Type | Individual |
| Full Name | BRET V WIXOM |
| Credential | LCSW |
| Practice Address |
3422 S 15th E Idaho Falls ID 83404 |
| Practice Telephone | 2085521222 |
| Practice Fax Number | 2085523377 |
| Mailing Telephone | 2085521222 |
| Mailing Fax Number | 2085523377 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
24803 | ID | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE CROSS OF IDAHO | L2649 | 01 |
| ID | REGENCE BLUE SHIELD OF ID | 000010143064 | 01 |
| Street Address |
3422 S 15TH E |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285621532 | Michael T Harris Md, PC | Clinic/Center | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2005-10-03 |
| 1760044424 | Phillip Marlowe | Radiologic Technologist | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2019-07-02 |
| 1215314968 | Hsiang-hua Wang | Counselor | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2015-05-01 |
| 1114343985 | Kelly Stark | Counselor | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2014-03-17 |
| 1912335738 | Family Resource Centers of America, Inc | Clinic/Center | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2013-10-15 |
| 1164712899 | Sawtooth Rehab, Pllc | Specialist | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2011-04-14 |
| 1720387681 | Travis Scott Hull | Social Worker | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2011-03-17 |
| 1376877795 | David Aaron Petty | Allergy & Immunology | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2009-10-01 |
| 1235363169 | Maria Teresa Alvarado | Counselor | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2009-05-06 |
| 1982841334 | Karen Elise Bender | Registered Nurse | 3422 S 15th E, The Healing Sanctuary, Idaho Falls, ID 83404-8262 | 2009-01-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1427618958 | Eastern Idaho Endodontics | Dentist | 3335 S. Holmes Ave, Idaho Falls, ID 83404 | 2019-06-17 |
| 1942863600 | Muhammad Arslan Khan | Student in an Organized Health Care Education/Training Program | 2860 Channing Way Suite 214, Idaho Falls, ID 83404 | 2019-04-18 |
| 1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1083196380 | Hannah Golden | Occupational Therapist | 1460 Elk Creek, Idaho Falls, ID 83404 | 2018-09-04 |
| 1316423049 | Lindsay Sessions | Speech-Language Pathologist | 2210 Niagara St, Idaho Falls, ID 83404 | 2018-07-16 |
| 1720574023 | Bmh, Inc. | Anesthesiology | 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 | 2018-07-10 |
| 1093237935 | Jason Earl Bailey | Contractor | 3100 S Woodruff Ave., Idaho Falls, ID 83404 | 2017-07-12 |
| 1235682121 | Mountain Falls Quick Care | Clinic/Center | 1995 E 17th St #1, Idaho Falls, ID 83404 | 2016-07-27 |
| Find all providers in zip 83404 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164040820 | Sylinda Lee Mendenhall | Social Worker | 771 S Jafer Court, Idaho Falls, ID 83401-8404 | 2020-07-09 |
| 1750847786 | Brandi S Warnke | Social Worker | 254 E Street, Suite B, Idaho Falls, ID 83402 | 2019-02-14 |
| 1487136420 | Ryan Brent Beckstead | Social Worker | 490 Park Ave Ste 4, Idaho Falls, ID 83402-1230 | 2018-09-06 |
| 1780100719 | Hope Mental Health | Social Worker | 2235 12th St, Idaho Falls, ID 83404-5703 | 2017-08-22 |
| 1427571736 | Wixom Counseling Inc | Social Worker | 4344 E Nibley Cir, Idaho Falls, ID 83401-3783 | 2017-07-18 |
| 1306376843 | Rachel Clark | Social Worker | 2235 12th St Apt F146, Idaho Falls, ID 83404-5743 | 2017-06-18 |
| 1962881482 | Megan Howard | Social Worker | 1970 E 17th St Ste 208, Idaho Falls, ID 83404-8048 | 2015-05-29 |
| 1073906012 | Candis Caye Moss | Social Worker | 2678 Galway Cir, Idaho Falls, ID 83404-7392 | 2015-03-16 |
| 1649660663 | Christopher Brayton | Social Worker | 1553 S Lee Ave, Idaho Falls, ID 83404-5936 | 2015-01-29 |
| 1184026619 | Stephanie Christensen | Social Worker | 2635 Channing Way Ste B, Idaho Falls, ID 83404-7518 | 2014-09-16 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83404 |
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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.