Organization
WIXOM COUNSELING ONLINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRET V WIXOM MSW LCSW (OWNER)
(208) 521-4433
Entity
Organization
Contact information
Practice address
4344 E NIBLEY CIR, IDAHO FALLS, ID 83401-3783
(208) 521-4433
(208) 538-2233
Mailing address
4344 E NIBLEY CIR, IDAHO FALLS, ID 83401-3783
(208) 521-4433
(208) 538-2233
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/30/2025
Last updated
12/30/2025
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