Tiffany Ann Bascom, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC-3801 Issued in ID

Practice address

2520 S 5TH Ave
Pocatello, ID 83204-1923

Phone

(208) 233-5433

NPI assigned

Jan 4, 2007

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

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

Specialty

Mental Health Counselor

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Life Change Associates PCGroup PAC ID 8224265574, 7 clinicians

Practice addresses (Care Compare)

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.

• Life Change Associates, PC

  • Psychiatry Physician
  • Pocatello, ID
  • NPI 1598077562

  Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1487701058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 S 5TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832041923",
            "telephone_number": "208-233-5433",
            "fax_number": "208-284-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 S 5TH AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832041923",
            "telephone_number": "208-233-5433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 S 11th Ave",
            "address_2": "Suite 302",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832014835",
            "country_code": "US",
            "telephone_number": "208-233-0150",
            "fax_number": "208-233-0159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASCOM",
        "first_name": "TIFFANY",
        "middle_name": "ANN",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-3801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Tara Barlow, PT
• Chandra Barney, SLPA
• Whitney Barney, LCSW
• Harriet Barratt, M.D.
• Cynthia Love Barron, CNS
• James Oran Basinger
• Barrett Richard Batchelder, CRNA
• Brandy M Bates, PA-C
• Sadie Bauer, NP
• Bay Roots Counseling

• Mental Health Counselor in Pocatello, ID
• Providers in Pocatello, 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 Dec 18, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.