Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tiffany Ann Bascom, LCPC

Individual provider Mental Health Counselor · NPI 1487701058

Tiffany Ann Bascom, LCPC is a Mental Health Counselor in Pocatello, Idaho. Qualified in 2003, 23 years ago. Practices with Life Change Associates PC, a 7-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Idaho.

Years since qualifying
23
Licensed in
ID
In the registry since
2007
What do these letters mean?
LCPC — Licensed Clinical Professional Counselor
A licensed clinical counsellor.

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Practice location Address checks out

2520 S 5th Ave
Pocatello, ID 83204-1923
Phone: (208) 233-5433
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 500 S 11th Ave, Pocatello, ID 83201-4835 — (208) 233-0150

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LCPC-3801 (ID)

Record details

NPI number1487701058
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCPC
Sole proprietorNo
NPI enumeratedJanuary 4, 2007
Last updated in NPPESDecember 18, 2023
Certification dateDecember 14, 2023
Mailing address2520 S 5th Ave, Pocatello, ID 83204-1923

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Life Change Associates Pc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Pocatello