Individual provider Active NPI

Michaela Wall

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1457184517
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
148 S Cole Rd
Boise, ID 83709-0932
Phone
(208) 683-8320
NPI assigned
Aug 23, 2024
Last updated
Aug 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

148 S Cole Rd
Boise, ID 83709-0932

Mailing address

450 W Grove St Apt 408
Boise, ID 83702-7282
Phone (805) 660-3618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
A Body & Mind Health Services, LLC Mental Health CurrentSince Aug 25, 2024 Accepting new patients
A Body & Mind Health Services, LLC Mental Health CurrentSince Aug 25, 2024 Accepting new patients

Locations

148 S Cole Rd
Boise, ID 83709

509 S Middleton Rd
Ste 104
Middleton, ID 83644
Phone 2086838320 ext. 38320

213 N Main St
Ste 1B
Moscow, ID 83843
Phone 2086838320 ext. 38320

496 Shoup Ave W
Ste F
Twin Falls, ID 83301
Phone (208) 733-6882

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1457184517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 W GROVE ST APT 408",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837027282",
            "telephone_number": "805-660-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 S COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837090932",
            "telephone_number": "208-683-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "MICHAELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.