Kathleen McCann Deidrick, PHD
NPI 1891742540ActiveIndividual· Psychologist, Clinical· Boise, ID
Psychologist, Clinical (PHD) in Boise, Idaho, licensed in ID and MO, with an NPI issued in May 2006. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1891742540 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | No |
| NPI issued | May 28, 2006 |
| Last updated in NPPES | Feb 21, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | PSY202777 | ID |
| Psychologist, Clinical | 103TC0700X | 2003023860 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (ID) |
|---|
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