ZACHARY WIXOM (NPI# 1023507977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023507977 |
| Entity Type | Individual |
| Full Name | ZACHARY WIXOM |
| Credential | LMSW |
| Practice Address |
150 Shoup Ave Idaho Falls ID 83402-3657 |
| Practice Telephone | 2085285712 |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2018-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
150 SHOUP AVE |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83402-3657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275669152 | Idaho Dept of Health & Welfare Region 7 Amh Psr If | Clinic/Center | 150 Shoup Ave, Suite 17, Idaho Falls, ID 83402-3657 | 2007-02-26 |
| 1639733256 | Michaelina S Page | Registered Nurse | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2019-04-29 |
| 1013489285 | Maria Rodriguez-moncada | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2018-12-27 |
| 1437626124 | Elizabeth Rae Lagazo | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2018-10-31 |
| 1942784756 | Robert Creighton Shumway | Physician Assistant | 150 Shoup Ave, #170, Idaho Falls, ID 83402 | 2018-09-18 |
| 1841723822 | Jennifer Lebel | Registered Nurse | 150 Shoup Ave, Suite 17, Idaho Falls, ID 83402-3657 | 2017-04-06 |
| 1194264127 | Timothy Mchugh | Physician Assistant | 150 Shoup Ave, Suite 17, Idaho Falls, ID 83402-3657 | 2017-02-23 |
| 1740730811 | Nichole Chauntelle Wilson | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2016-10-12 |
| 1700331279 | Kayla Schroeder | Speech-Language Pathologist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2016-08-24 |
| 1306296488 | Marie Sheranian | Developmental Therapist | 150 Shoup Ave, Idaho Falls, ID 83402-3657 | 2016-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648015 | Abigail Oakley | Counselor | Tueller Counseling Services, 2275 W Broadway Suite G, Idaho Falls, ID 83402 | 2020-10-30 |
| 1265041479 | Fresenius Medical Care Snake River | Clinic/Center | 3195 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-24 |
| 1295352391 | Fresenius Medical Care Idaho Falls, LLC | Clinic/Center | 3193 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-06 |
| 1952923765 | Sterling Provider Group | Clinic/Center | 7017 Daisy Lane, Idaho Falls, ID 83402 | 2020-05-14 |
| 1528604188 | Leslie Hendrian | Massage Therapist | 86 N Kaylee Circle, Idaho Falls, ID 83402 | 2019-11-19 |
| 1154966760 | Christine Nicole Cardona | Counselor | 855 N. Captital Ave Ste 1, Idaho Falls, ID 83402 | 2019-11-07 |
| 1750847786 | Brandi S Warnke | Social Worker | 254 E Street, Suite B, Idaho Falls, ID 83402 | 2019-02-14 |
| 1013402809 | Kailey Lynn Moore | Pharmacist | 376 West 18th Street, Idaho Falls, ID 83402 | 2018-06-25 |
| 1407368616 | Jessica Owsley | Social Worker | 2275 W Broadway Ste G, Idaho Falls, ID 83402 | 2017-10-27 |
| 1427419886 | Becky Allen | Developmental Therapist | 150 Shoupe Ave, Idaho Falls, ID 83402 | 2016-03-14 |
| Find all providers in zip 83402 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609410489 | Angelika H Gutenberger | Counselor | 211 S Woodruff Ave Ste A3, Idaho Falls, ID 83401-4865 | 2019-11-04 |
| 1851859110 | Rebecca Chidester | Counselor | 771 Parkwood St., Idaho Falls, ID 83401 | 2019-03-06 |
| 1124590302 | A Penney for Your Thoughts, LLC | Counselor | 1820 E 17th St Ste 190, Idaho Falls, ID 83404-6518 | 2018-12-27 |
| 1346790128 | Molli Gilchrist | Counselor | 760 K St Apt B, Idaho Falls, ID 83402-2770 | 2016-10-05 |
| 1508256850 | Itzel Montero | Counselor | 3442 S. 15th E., Idaho Falls, ID 83404 | 2015-01-26 |
| 1457610149 | Kimberly W. Johnson | Counselor | 1934 N 26th W, Idaho Falls, ID 83402-5319 | 2012-05-15 |
| 1477823490 | Annette Marie Cowley | Counselor | 1273 E 17th St, Idaho Falls, ID 83404-6126 | 2012-01-06 |
| 1619102183 | Quinn Blake Thibodeau | Counselor | 1891 Grandview Ct, Idaho Falls, ID 83402-2510 | 2009-05-27 |
| 1679711998 | New Journeys Inc | Counselor | 1047 Oxbow Ln, Idaho Falls, ID 83404-8351 | 2009-01-23 |
| 1093964041 | Nathan James Fullmer | Counselor | 4707 1st St, Idaho Falls, ID 83401-5771 | 2008-09-15 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83402 |
Please comment or provide details below to improve the information on ZACHARY WIXOM.
| 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.