MEDICARE: MICHELLE LYNN DRINKWINE LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	210	ID
2	101YP2500X	Professional Counselor	210	ID

General Provider Information

NPI Number	:	1083130116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE LYNN DRINKWINE LCPC

Provider Business Mailing Address
First Line	:	718 S 7TH AVE
Second Line	:
City	:	CALDWELL
State	:	ID
Zip	:	83605-4104
Country	:	US
Telephone Number	:	208-454-1576
Fax Number	:

Provider Business Practice Location Address
First Line	:	718 S 7TH AVE
Second Line	:
City	:	CALDWELL
State	:	ID
Zip	:	83605-4104
Country	:	US
Telephone Number	:	208-454-1576
Fax Number	:	208-454-9863

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2017
Last Update Date	:	04/06/2026

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