Bret V. Wixom, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

24803 Issued in ID

Practice address

4344 E Nibley Cir
Idaho Falls, ID 83401-3783

Phone

(208) 521-4433

Fax

(208) 538-2233

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Wixom Counseling Online

  • Mental Health Counselor
  • Idaho Falls, ID
  • NPI 1942166277
  NPD Authorized official
• Family Resource Centers of America

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Idaho Falls, ID
  • NPI 1871604942

  Clinical

  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1720171358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4344 E NIBLEY CIR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834013783",
            "telephone_number": "208-521-4433",
            "fax_number": "208-538-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4344 E NIBLEY CIR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834013783",
            "telephone_number": "208-521-4433",
            "fax_number": "208-538-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIXOM",
        "first_name": "BRET",
        "middle_name": "V.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "24803",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "5450383-3501",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "L2649",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "000010143064",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wirick Family Chiropractic
• Brady Matthew Wirick, D,C,
• Shane Oliver Withers Jr., PHARMD, BCPS
• Wixom Counseling Inc
• Wixom Counseling Online
• Jordan Wixom, LPC, NCC
• Zachary Wixom, LMSW
• Women'S Healthcare Associates
• Women'S Healthcare Associates, P.a.
• Jerrilynne Wood, LCPC-4457

• Clinical Social Worker in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; 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.