JACLYN MOORE (NPI# 1992186506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992186506 |
Entity Type | Individual |
Full Name | JACLYN MOORE |
Credential | LCPC |
Practice Address |
2577 S Five Mile Rd Ste 101 Boise ID 83709 |
Mailing Address |
2577 S Five Mile Rd Ste 101 Boise ID 83709-2325 |
Practice Telephone | 2086391897 |
Practice Fax Number | 2086399957 |
Mailing Telephone | 2086391897 |
Mailing Fax Number | 2086399957 |
Enumeration Date | 2015-06-10 |
Last Update Date | 2018-08-16 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YM0800X |
Counselor Specialization: Mental Health |
6879 | ID | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629684907 | Jaclyn Vaughn Moore | Dietitian, Registered | 234 E Gray St Ste 164, Louisville, KY 40202-1903 | 2020-09-22 |
1114428364 | Jaclyn Marie Moore | Occupational Therapist | 10000 Telegraph Rd, Taylor, MI 48180-3330 | 2018-02-23 |
1992137848 | Jaclyn M Moore | Licensed Practical Nurse | 777 37th St, Suite B107, Vero Beach, FL 32960-4873 | 2013-08-02 |
1679739759 | Jaclyn Moore | Technician | 19401 Northline Rd, Southgate, MI 48195-2277 | 2008-07-29 |
1073669354 | Jaclyn Lee Moore | Pharmacist | 67-1185 Mamalahoa Hwy, Kamuela, HI 96743-7304 | 2007-01-26 |
Street Address |
2577 S FIVE MILE RD STE 101 |
City | BOISE |
State | ID |
Zip Code | 83709 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427655398 | Jayme Rossow | Occupational Therapist | 101 S. Allumbaugh Way, Boise, ID 83709 | 2020-10-05 |
1578195285 | Kara Taylor | Counselor | 9196 W Barnes St., Boise, ID 83709 | 2020-02-11 |
1164080164 | Elena Stamm | Audiologist | 10000 W Amity Rd, Boise, ID 83709 | 2019-06-04 |
1326550096 | Lawrence D Anderson Md Estate | Optometrist | 8955 W Hackamore Dr, Boise, ID 83709 | 2017-11-02 |
1457879975 | Mark Aaron Phelan | Registered Nurse | 779 S. Tennyson Way, Boise, ID 83709 | 2017-09-05 |
1235665290 | Sharon Nelson | Dietitian, Registered | 2790 S Goshen Way, Boise, ID 83709 | 2017-05-11 |
1982139622 | First Choice Healthcare, Inc. | Home Health | 12400 W. Overland Rd., Ste 100, Boise, ID 83709 | 2017-05-01 |
1801320254 | Deborah Carson | Social Worker | 8349 West Harmonica Way, Boise, ID 83709 | 2017-04-12 |
1114479862 | Allyson Anne Bates | Nurse Practitioner | 10583 W Lake Hazel Road, Samg Family Medicine, Boise, ID 83709 | 2016-10-28 |
1508221391 | Elisha L. Garrison | Counselor | 9196 W. Barnes Street, Boise, ID 83709 | 2015-12-21 |
Find all providers in zip 83709 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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 |
1891316972 | Mary Lott | Counselor | 6300 W Denton St, Boise, ID 83704-9326 | 2020-04-30 |
1750900429 | Patrick Barga | Counselor | 344 S Latah St Apt 202, Boise, ID 83705-5175 | 2020-04-13 |
1184254146 | Emily Diane Bergstrom | Counselor | 2365 N 34th St, Boise, ID 83703-5523 | 2020-01-18 |
1073150033 | Allegiance Behavioral Health LLC | Counselor | 1010 N Orchard St Ste 1a, Boise, ID 83706-2255 | 2019-12-09 |
1841836178 | Hopeful Connections Parenting, LLC | Counselor | 1027 S Curtis Rd, Boise, ID 83705-1842 | 2019-11-21 |
1528601440 | Idaho Federtion of Families | Counselor | 704 N 7th St, Boise, ID 83702-5503 | 2019-10-23 |
1073154175 | A Better Life Counseling Pllc | Counselor | 4948 W Kootenai St Ste 102, Boise, ID 83705-2081 | 2019-10-01 |
1265087522 | Rosalie Lacivita | Counselor | 921 S Orchard St Ste 100, Boise, ID 83705-1916 | 2019-08-05 |
Find all providers in BOISE |
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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.