Shayla Renee Hickman, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LCPC-7945 Issued in ID

Practice address

2705 E 17TH St
Ammon, ID 83406-6601

Phone

(208) 346-7500

Fax

(208) 346-7501

NPI assigned

Jul 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shayla Renee Anderson Former name

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pearl Health Clinic

  • Mental Health Counselor
  • Ammon, ID
  • NPI 1447426465
  Medicare reassignment NPD
• Authentic Connections Counseling

  • Professional Counselor
  • Ammon, ID
  • NPI 1629815766
  NPD Authorized official
• Authentic Connections Counseling LLC

  • Professional Counselor
  • Idaho Falls, ID
  • NPI 1114764354
  NPD Authorized official

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1225515299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 E 17TH ST",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066601",
            "telephone_number": "208-346-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 E 17TH ST",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066601",
            "telephone_number": "208-346-7500",
            "fax_number": "208-346-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "SHAYLA",
        "middle_name": "RENEE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LCPC-7945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAYLA",
            "last_name": "ANDERSON",
            "middle_name": "RENEE",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Heiner, LMSW
• Kathy Jean Hemming, PA-C
• Allison Henrie, RD
• Marta Herrera, CPSS, CRC(P), YSP
• Joni Sue Hiatt
• Michael Andrew Hill, LPC
• Aaron Himrich
• Christina Hollist
• Home Health Harbor LLC
• David Charles Homer, LCSW

• Professional Counselor in Ammon, ID
• Providers in Ammon, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.