Provider Demographics
NPI:1588055875
Name:HOPKINS, MICHELLE CARDA (LCPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CARDA
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 190785
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83719-0785
Mailing Address - Country:US
Mailing Address - Phone:208-284-4635
Mailing Address - Fax:
Practice Address - Street 1:1350 S FIVE MILE RD #190785
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-8370
Practice Address - Country:US
Practice Address - Phone:208-284-4635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-09
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-6555101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health