MS. CAROL TIDWELL (NPI# 1003250754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003250754 |
| Entity Type | Individual |
| Full Name | MS. CAROL TIDWELL |
| Credential | MS. LCPC |
| Practice Address |
11104 W State St Star ID 83669 |
| Mailing Address |
2205 W Breneman St Boise ID 83702-0540 |
| Practice Telephone | 2085461808 |
| Mailing Telephone | 2087949502 |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2013-04-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LCPC-5223 | ID | Behavioral Health & Social Service Providers |
| Street Address |
11104 W STATE ST |
| City | STAR |
| State | ID |
| Zip Code | 83669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861999377 | Bi-mart Corporation | Pharmacy | 11347 W State Street, Star, ID 83669 | 2018-04-11 |
| 1285014779 | Boise River Physical Therapy | Physical Therapist | 64 S Star Road, Suite 2, Star, ID 83669 | 2015-06-01 |
| 1780816652 | Mark Olsen | Dentist | 12192 Evely Pines Ln, Star, ID 83669 | 2009-08-11 |
| 1770759912 | Richard E. Adams | Chiropractor | 11231 W Hercules Dr A, Star, ID 83669 | 2008-05-07 |
| 1861674707 | Keen Eye Vision Pllc | Optometrist | 170 South Seneca Springs Way, Suite 100, Star, ID 83669 | 2007-12-03 |
| 1639358773 | Natural Smile Dental Pllc | Dentist | 10706 W State St, Suite 105, Star, ID 83669 | 2007-10-25 |
| 1659566727 | Allied Mental Health Services, P.l.l.c. | Case Management | 11104 W. State St., Star, ID 83669 | 2007-09-11 |
| 1972709103 | Martin A Mangan | Family Medicine | 10717 W State Street, Star, ID 83669 | 2007-06-25 |
| 1699021246 | Leslie Leet | Social Worker | 246 N Main St, Star, ID 83669 | 2012-08-01 |
| 1649589664 | Katherine Lea Mcdonough | Family Medicine | 10717 W State Street, Star, ID 83669 | 2010-09-26 |
| Find all providers in zip 83669 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083135289 | Tanya Barnes | Counselor | 9628 W State St, Star, ID 83669-5858 | 2017-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255881 | Gerlyn Danette Walker | Counselor | 414 N Lincoln Ave Ste 1, Jerome, ID 83338-2300 | 2020-11-03 |
| 1811595929 | Idaho State University | Counselor | 1400 E Terry Dr Bldg 63, Pocatello, ID 83209-0001 | 2020-10-12 |
| 1013514728 | Rebecca Rand Counseling LLC | Counselor | 136 S Academy Ave Ste G, Eagle, ID 83616-6541 | 2020-10-06 |
| 1689271843 | Krystle May Sears | Counselor | 1550 N Crestmont Dr Ste A, Meridian, ID 83642-2177 | 2020-10-01 |
| 1437761491 | Bridges Behavioral Health LLC | Counselor | 16810 N Dartmouth Ave, Nampa, ID 83687-3028 | 2020-08-20 |
| 1891307815 | Pointview Counseling LLC | Counselor | 5700 E Franklin Rd Ste 220b, Nampa, ID 83687-7903 | 2020-08-20 |
| 1003425547 | Jennifer Weseman | Counselor | 6305 W Overland Rd Ste 100, Boise, ID 83709-3029 | 2020-07-30 |
| 1801405766 | Kristin Sue Richards | Counselor | 2000 N Larch St, Boise, ID 83706-1020 | 2020-07-27 |
| 1356959787 | Heidi Alyssa Stark | Counselor | 4024 Ivy Dr, Nampa, ID 83686-8852 | 2020-07-22 |
| 1316563505 | Family Health Services Corporation | Counselor | 607 2nd Ave E, Twin Falls, ID 83301-7128 | 2020-06-23 |
| 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.