Brian Butler Mecham, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-1335 Issued in ID

Practice address

1165 S Utah Ave
Idaho Falls, ID 83402-3321

Phone

(208) 522-6155

Fax

(208) 522-6156

NPI assigned

Jun 14, 2012

Last updated

Jun 14, 2012By 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

State licenses

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1326300310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3069 SUMMERWOOD CIR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834067540",
            "telephone_number": "208-552-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 S UTAH AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023321",
            "telephone_number": "208-522-6155",
            "fax_number": "208-522-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MECHAM",
        "first_name": "BRIAN",
        "middle_name": "BUTLER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-14",
        "last_updated": "2012-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-1335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malinda McRea, FNP-C
• Kelly Meacham, PA-C
• Meadowbrook Counseling of Idaho, LLC (Meadowbrook Counseling of Idaho)
• Haylee Mears
• Andrea M Mecham
• Hannah Marie Lynn Mecham, MOTR/L
• Skye Mecham, LMSW
• Victoria L Mecham, LCSW
• Medical Center for Children & Adolescents, PA (The Pediatric Center)
• Donalee Fife Meek, LMSW

• Clinical Social Worker in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; 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.