LACEY MEGORDEN


Address: 4222 W Emerald St, Boise, ID 83706-2037
Phone: 2086053663

LACEY MEGORDEN (NPI# 1881157949) 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) 1881157949
Entity Type Individual
Full Name LACEY MEGORDEN
Credential BS
Practice Address 4222 W Emerald St
Boise
ID 83706-2037
Practice Telephone 2086053663
Practice Fax Number 2086053663
Mailing Telephone 2086053663
Enumeration Date 2019-04-07
Last Update Date 2019-04-07
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 175T00000X Peer Specialist ID Other Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
ID 1 05

Office Location

Street Address 4222 W EMERALD ST
City BOISE
State ID
Zip Code 83706-2037

Providers in the same location

NPI Name Taxonomy Address Enumeration
1972073401 Zulaen R Fernandez Counselor 4222 W Emerald St, Boise, ID 83706-2037 2018-11-27
1770147944 Trudy Nebeker Case Manager/Care Coordinator 4222 W Emerald St, Boise, ID 83706-2037 2019-04-23
1346707965 Ann Marie Walker Social Worker 4222 W Emerald St, Boise, ID 83706-2037 2019-03-01

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164993010 Brette Marie Stephenson Counselor 1529 Belmont St., Boise, ID 83706 2018-12-17
1295249241 Boise of Cascadia, LLC Skilled Nursing Facility 6000 W. Denton St., Boise, ID 83706 2017-11-29
1174035638 Zacharia Njoroge Physician Assistant 1055 N Curtis Rd 6th Floor, Boise, ID 83706 2017-10-24
1740708965 Total Renal Care Inc Clinic/Center 1070 N Curtis Rd Ste 125, Boise, ID 83706 2017-09-08
1023532173 Amber Frisch Massage Therapist 2509 S Gekeler Lane, Boise, ID 83706 2017-07-31
1952768145 Katie Garcin Specialist 1407 E Boston Dr, Boise, ID 83706 2016-01-20
1770950677 Kathryn Bender Counselor 1205 N Garden St, Boise, ID 83706 2015-08-26
1457751802 Sabrina Shumar Physician Assistant 901 N Curtis Rd Ste 501, Boise, ID 83706 2014-09-03
1831525070 Katie Joy Wilson Social Worker 333 W. Rossi St. #300, Boise, ID 83706 2013-09-19
1609208610 Christine Lea Eden Surgery 1075 N Curtis Rd Ste 101, Boise, ID 83706 2013-07-31
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Taxonomy Information

Taxonomy Code 175T00000X
Grouping Other Service Providers
Classification Peer Specialist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1306481817 Ability Health and Rehabilitation LLC Peer Specialist 10101 W Overland Rd Ste 110, Boise, ID 83709-1429 2019-11-08
1073127791 Calm Waters Counseling Pllc Peer Specialist 10108 W Overland Rd Ste A, Boise, ID 83709-1428 2020-09-01
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
1235613688 Devin R Pugmire Peer Specialist 300 S 23rd St, Boise, ID 83702-9100 2018-09-21
1255793659 Michele Hickman Peer Specialist 1720 N Westgate Dr, Boise, ID 83704-7164 2016-03-24
1255719092 Matthew Caleb Weaver Peer Specialist 300 S 23rd St, Boise, ID 83702-9100 2015-05-13

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
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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City BOISE
Zip Code 83706

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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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