NPIMap

Organization Active NPI

Icare Center for Change

Doing business as iCareTeleCare

  • Addiction (Substance Use Disorder) Psychologist
  • Buhl, ID
National Provider Identifier
1508554940
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X
Legal business name
ICARE CENTER FOR CHANGE
Doing business as
iCareTeleCare
Practice address
1689 E 4000 N
Buhl, ID 83316-5647
Phone
(208) 918-2473
NPI assigned
Apr 25, 2023
Last updated
Apr 25, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ICARE TELECAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Authorized official

Name
Kelly Graff, APRN-CNSNPI 1326717141
Title
Owner, Clinician
Phone
(208) 918-2473

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TA0400X Primary

Addresses

Primary practice location

1689 E 4000 N
Buhl, ID 83316-5647

Mailing address

1689 E 4000 N
Buhl, ID 83316-5647
Phone (208) 918-2473

Other names 1

  • iCareTeleCare Doing business as

National Provider Directory

National Provider Directory
Part of
Icare Telecare

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1508554940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1689 E 4000 N",
            "city": "BUHL",
            "state": "ID",
            "postal_code": "833165647",
            "telephone_number": "208-918-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1689 E 4000 N",
            "city": "BUHL",
            "state": "ID",
            "postal_code": "833165647",
            "telephone_number": "208-918-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICARE CENTER FOR CHANGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ICARE TELECARE",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "GRAFF",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER, CLINICIAN",
        "authorized_official_telephone_number": "208-918-2473",
        "authorized_official_credential": "APRN-CNS"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "iCareTeleCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buhl, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.