Icare Center for Change
Organization Active NPI Addiction (Substance Use Disorder) Psychologist · Buhl, ID
NPI 1508554940 · NPPES record last updated Apr 25, 2023
Key facts
- NPI
- 1508554940
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Addiction (Substance Use Disorder) Psychologist 103TA0400X
- Legal business name
- ICARE CENTER FOR CHANGE
- Practice address
- 1689 E 4000 N
Buhl, ID 83316-5647 - Phone
- (208) 918-2473
- NPI assigned
- Apr 25, 2023
- Organization subpart
- Yes
- Parent organization (as reported)
- ICARE TELECARE
Authorized official
- Name
- Kelly Graff, APRN-CNS
- Title
- Owner, Clinician
- Phone
- (208) 918-2473
Parent organization (reported in NPPES) 1
Practitioners 1
-
Kelly K Graff, APRN-CNS
National Provider Directory
- Part of
- Icare Telecare PLLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Psychologist |
103TA0400X | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558567107 | Medicaid | ID |
Other names
- iCareTeleCare
Other providers in Buhl, ID
- Kelly K Graff
- Rorri Henstock
- Michael V Higbee
- Austin Ivins Higginson
- Anna Howard
- Michelle Kruse Imani
- Loriann Jones
- K2Red LLC
- Spencer Kelsey
- Clayton Kline
All providers in Buhl, ID · Addiction (Substance Use Disorder) Psychologist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.