LACEY MEGORDEN (NPI# 1881157949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 175T00000X | Peer Specialist | ID | Other Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ID | 1 | 05 |
Street Address |
4222 W EMERALD ST |
City | BOISE |
State | ID |
Zip Code | 83706-2037 |
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 |
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 |
Find all providers in zip 83706 |
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] |
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 |
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 |
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.