Matthew Duane Millican, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-6347 Issued in ID

Practice address

123 McClure Ave
Nampa, ID 83651-2057

Phone

(208) 461-3720

NPI assigned

Nov 29, 2016

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

Credentials

Master of Arts

State licenses

Practice roles

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.

• Cook Behavioral Health LLC

  • Community/Behavioral Health Agency
  • Nampa, ID
  • NPI 1538603667
  NPD (past)

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1316480973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 SW 2ND AVE",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979144512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 MCCLURE AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836512057",
            "telephone_number": "208-461-3720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLICAN",
        "first_name": "MATTHEW",
        "middle_name": "DUANE",
        "name_prefix": "Mr.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-29",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-6347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Miller, RN
• Krystle Miller
• Melanie Miller, HIS
• Rachael Miller
• Sara Miller, M.S. CCC-SLP
• Devin Alan Milliron, FNP
• Katherine Claire Mills, PHARMD
• Michael Holdcroft Millward, MD
• Jennifer Jean Mimish, CNM, WHNP
• Brian Ora Minasian, PHARM D

• Mental Health Counselor in Nampa, ID
• Providers in Nampa, 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 Nov 29, 2016; 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.