Zachary Wixom, LMSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

150 Shoup Ave
Idaho Falls, ID 83402-3657

Phone

(208) 528-5712

NPI assigned

May 7, 2018

Last updated

May 7, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1023507977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SHOUP AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SHOUP AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023657",
            "telephone_number": "208-528-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIXOM",
        "first_name": "ZACHARY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-07",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shane Oliver Withers Jr., PHARMD, BCPS
• Wixom Counseling Inc
• Wixom Counseling Online
• Bret V. Wixom, LCSW
• Jordan Wixom, LPC, NCC
• Women's Healthcare Associates (Rosemark WomenCare Specialists (Mid-level Group))
• Women's Healthcare Associates, P.a. (Rosemark WomenCare Specialists and/or Margaret Huggins, MD)
• Aspen Sage Wood
• Jerrilynne Wood, LCPC-4457
• Kaydee Wood

• Mental Health Counselor in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.