Laura Ann Ickes, MS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0005232 Issued in CO

Practice address

87 Merchant Dr
Montrose, CO 81401-3015

Phone

(970) 252-8896

Fax

(970) 240-3095

NPI assigned

Jul 11, 2006

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

• Ms. Laura Ann Bashor Former name

Medicare fee-for-service enrollment

Enrolled in OK

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

Credentials

Master of Science

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.

• State of Oklahoma

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Norman, OK
  • NPI 1588755532
  Medicare reassignment NPD
• State of Oklahoma

  • Skilled Nursing Facility
  • Talihina, OK
  • NPI 1154589430
  NPD
• State of Oklahoma

  • Medical Specialty Clinic/Center
  • McAlester, OK
  • NPI 1689843559
  NPD

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1376577593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61055 DAVID RD",
            "city": "OLATHE",
            "state": "CO",
            "postal_code": "814259599",
            "telephone_number": "970-946-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 MERCHANT DR",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814013015",
            "telephone_number": "970-252-8896",
            "fax_number": "970-240-3095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2130 E Main St",
            "address_purpose": "LOCATION",
            "city": "Montrose",
            "state": "CO",
            "postal_code": "814013834",
            "country_code": "US",
            "telephone_number": "970-252-3233",
            "fax_number": "970-252-3208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ICKES",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0005232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "BASHOR",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Montrose, CO
• Providers in Montrose, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.