| Kavin Branham, LCPC | |
|
72 S 1st E Ste 103, Rexburg, ID 83440-1965 | |
| (208) 356-4900 | |
| (208) 624-4030 |
| Full Name | Kavin Branham |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 72 S 1st E Ste 103, Rexburg, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427409051 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LCPC-7894 (Idaho) | Primary |
| Entity Name | Upper Valley Community Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972792489 PECOS PAC ID: 4385725282 Enrollment ID: O20120611000120 |
| Mailing Address | Practice Location Address |
|---|---|
| Kavin Branham, LCPC Po Box 18, Saint Anthony, ID 83445-0018 Ph: (208) 356-4900 | Kavin Branham, LCPC 72 S 1st E Ste 103, Rexburg, ID 83440-1965 Ph: (208) 356-4900 |
Creed Simon Webster, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 30 S 2nd W, Rexburg, ID 83440 Phone: 208-709-7248 Fax: 208-496-5127 | |
Mr. Travis Paul Schwab, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 218 Dividend Dr Ste 3, Rexburg, ID 83440 Phone: 208-359-9683 | |
Erika Nordfelt, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 343 E 4th N Ste 200, Rexburg, ID 83440 Phone: 208-261-2131 | |
Mrs. Lori Annette Foster Miller, MCOUN., LPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 36 Professional Plz Ste 220, Rexburg, ID 83440 Phone: 208-821-3554 | |
Kansas Kauer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2265 W. Broadway St., Rexburg, ID 83440 Phone: 208-524-7400 | |
Mrs. Kirsten Lee Griggs, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 310 N 2nd E Ste 114, Rexburg, ID 83440 Phone: 208-359-0581 Fax: 208-359-1125 | |
Dalynn N Moore, MC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 393 E 2nd N, Rexburg, ID 83440 Phone: 208-359-4840 Fax: 208-359-9010 |