| Shayla Renee Hickman, LCPC | |
|
2705 E 17th St, Ammon, ID 83406-6601 | |
| (208) 346-7500 | |
| (208) 346-7501 |
| Full Name | Shayla Renee Hickman |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 2705 E 17th St, Ammon, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225515299 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LCPC-7945 (Idaho) | Primary |
| Entity Name | Pearl Health Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447426465 PECOS PAC ID: 0840356077 Enrollment ID: O20090312000617 |
| Mailing Address | Practice Location Address |
|---|---|
| Shayla Renee Hickman, LCPC 2705 E 17th St, Ammon, ID 83406-6601 Ph: (208) 346-7500 | Shayla Renee Hickman, LCPC 2705 E 17th St, Ammon, ID 83406-6601 Ph: (208) 346-7500 |
Ms. Alison Layton, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3453 Clearview Ln, Ammon, ID 83406 Phone: 208-359-4840 Fax: 208-359-9010 | |
Sonja Johnson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1675 Curlew Dr, Ammon, ID 83406 Phone: 208-523-5319 | |
Elizabeth Whitehead, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1323 Ammon Park Dr, Ammon, ID 83406 Phone: 208-932-8350 Fax: 208-938-2330 | |
Jodi Lynn Dennett, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2705 E 17th St, Ammon, ID 83406 Phone: 208-346-7500 | |
Siu Ling Chi, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2705 E 17th St, Ammon, ID 83406 Phone: 208-346-7500 | |
Mr. Zakery R Warren, LCPC4472 Counselor Medicare: Medicare Enrolled Practice Location: 2705 E 17th St Ste A, Ammon, ID 83406 Phone: 208-346-7500 Fax: 208-346-7501 | |
Angela Lynn Seal, BS, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 246 N Curlew Dr Apt 3105, Ammon, ID 83401 Phone: 208-569-6670 |