MR. LYLE SPENCER BOURCY (NPI# 1235130162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235130162 |
| Entity Type | Individual |
| Full Name | MR. LYLE SPENCER BOURCY |
| Credential | LCPC |
| Practice Address |
1303 Nw 16th St Suite C Fruitland ID 83619-2263 |
| Practice Telephone | 2082500374 |
| Practice Fax Number | 2084522164 |
| Mailing Telephone | 2082500374 |
| Mailing Fax Number | 2084522164 |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LCPC-2757 | ID | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | BLUE SHIELD OF IDAHO | 0000101364 | 01 |
| ID | BLUE CROSS OF IDAHO PROVI | Q3543 | 01 |
| Street Address |
1303 NW 16TH ST SUITE C |
| City | FRUITLAND |
| State | ID |
| Zip Code | 83619-2263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992322382 | Dallin Scott Wilkes | Physical Therapist | 2175 N Whitley Dr., Fruitland, ID 83619 | 2020-07-01 |
| 1659925113 | Treasure Valley Classical Academy | Local Education Agency (LEA) | 500 Sw 3rd Street, Fruitland, ID 83619 | 2019-08-01 |
| 1083146559 | Total Renal Care, Inc. | Clinic/Center | 815 Nw 13th St, Fruitland, ID 83619 | 2017-04-03 |
| 1154563948 | Becky Jean Wolery | Social Worker | 910 Nw 16th St Ste 101, Fruitland, ID 83619 | 2009-03-25 |
| 1740426196 | John Wesley Linhart | Physical Therapist | 1116 Nw 16th Street, Fruitland, ID 83619 | 2009-01-06 |
| 1528263670 | Snake River Dermatology, Pa | Dermatology | 1611 N Whitley Dr, #7, Fruitland, ID 83619 | 2007-06-19 |
| 1568591204 | John Linton Close | Registered Nurse | 1509 N Whitley Drive, Suite 5, Fruitland, ID 83619 | 2007-03-05 |
| 1629110671 | Payette School Dist #373 | Local Education Agency (LEA) | 303 Sw 3rd Street, Fruitland, ID 83619 | 2007-02-13 |
| 1912075839 | William Frederick Martsch | Dentist | 315 N. Whitley, Fruitland, ID 83619 | 2006-11-30 |
| 1992880132 | Ryan David Hillam | Dentist | 1820 N.whitley Drive, Fruitland, ID 83619 | 2006-10-26 |
| Find all providers in zip 83619 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669897591 | Christian Counseling Services | Counselor | 100 S Iowa Ave, 100 S Iowa Ave, Fruitland, ID 83619-2644 | 2014-03-01 |
| 1922119015 | Terry A. Buster | Counselor | 1509 N Whitley Dr, Suite 11, Fruitland, ID 83619-2259 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648015 | Abigail Oakley | Counselor | Tueller Counseling Services, 2275 W Broadway Suite G, Idaho Falls, ID 83402 | 2020-10-30 |
| 1679172472 | Dynisha Smith | Counselor | 9277 W Shoup Ave, Boise, ID 83709-0557 | 2020-10-22 |
| 1710592142 | Bruce F. Pagano II | Counselor | 1217 3rd St S Ste 103, Nampa, ID 83651-3917 | 2020-09-11 |
| 1881208056 | Cameron Cushing | Counselor | 3293 E Plympton Dr, Meridian, ID 83642-9019 | 2020-09-03 |
| 1689285892 | Jacob Santhouse | Counselor | 824 17th Ave S Ste 7, Nampa, ID 83651-4781 | 2020-08-11 |
| 1487264032 | Esteem Counseling, LLC | Counselor | 1404 North Marcasite Court, Post Falls, ID 83854 | 2020-08-07 |
| 1669081311 | Catherine Leavitt | Counselor | 921 S 8th Ave # 8136, Pocatello, ID 83209-0002 | 2020-07-29 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1013535145 | Revitalize Consulting Group, Inc. | Counselor | 202 S Midland Blvd, Nampa, ID 83686-2602 | 2020-07-06 |
| 1427670314 | Richard Meyers | Counselor | 2052 Jennie Lee Dr Ste 2, Idaho Falls, ID 83404-7056 | 2020-05-13 |
| 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.