Provider Demographics
NPI:1417339730
Name:BIGGINS, MICHAEL (MED, CADC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:BIGGINS
Suffix:
Gender:M
Credentials:MED, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3804 W NORMANDIE DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-4729
Mailing Address - Country:US
Mailing Address - Phone:208-761-8636
Mailing Address - Fax:
Practice Address - Street 1:3804 W NORMANDIE DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-4729
Practice Address - Country:US
Practice Address - Phone:208-761-8636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)