MENTAL WELLNESS CLINIC OF COEUR D ALENE (NPI# 1598116659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1598116659 |
Entity Type | Organization |
Organization Name | MENTAL WELLNESS CLINIC OF COEUR D ALENE |
Practice Address |
1105 W Ironwood Dr Coeur D Alene ID 83814-2613 |
Practice Telephone | 2089649258 |
Practice Fax Number | 2086761009 |
Mailing Telephone | 2089649258 |
Mailing Fax Number | 2086761009 |
Enumeration Date | 2016-06-29 |
Last Update Date | 2016-06-29 |
Authorized Official Name | BRANDI MEEKS (ADMINISTRATOR) |
Authorized Official Telephone | 2089649258 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 175T00000X | Peer Specialist | Other Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ID | IDTPID000377 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619195344 | Mental Wellness Clinic of Coeur D Alene | Case Manager/Care Coordinator | 500 N Government Way, Suite 100, Coeur D Alene, ID 83814-2913 | 2007-04-20 |
1629429782 | Mental Wellness Clinic of Coeur D Alene | Community/Behavioral Health | 1105 W Ironwood Dr, Coeur D Alene, ID 83814-2613 | 2016-06-29 |
1376763474 | Mental Wellness Clinic of Coeur D Alene | Specialist | 500 N Government Way, Suite 100, Coeur D Alene, ID 83814-2913 | 2007-04-30 |
Street Address |
1105 W IRONWOOD DR |
City | COEUR D ALENE |
State | ID |
Zip Code | 83814-2613 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871713925 | Mental Wellness Clinic of Coeur D Alene Inc | Community/Behavioral Health | 1105 W Ironwood Dr, Coeur D Alene, ID 83814-2613 | 2007-04-30 |
1912524497 | Suzanne M Danner | Social Worker | 1105 W Ironwood Dr, Coeur D Alene, ID 83814-2613 | 2020-06-30 |
1013570936 | Carmen Jeffrey | Social Worker | 1105 W Ironwood Dr, Coeur D Alene, ID 83814 | 2019-04-16 |
1982184644 | Jonathan Zucker | Social Worker | 1105 W Ironwood Dr, Coeur D Alene, ID 83814-2613 | 2018-08-21 |
1316474745 | Kari Crowell-longman | Counselor | 1105 W Ironwood Dr, Coeur D Alene, ID 83814-2613 | 2017-05-16 |
1629429782 | Mental Wellness Clinic of Coeur D Alene | Community/Behavioral Health | 1105 W Ironwood Dr, Coeur D Alene, ID 83814-2613 | 2016-06-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
Find all providers in zip 83814 |
Taxonomy Code | 175T00000X |
Grouping | Other Service Providers |
Classification | Peer Specialist |
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962033399 | Lookout Behavioral Health LLC | Peer Specialist | 7905 N Meadowlark Way Ste A, Coeur D Alene, ID 83815-5041 | 2020-02-04 |
1164063285 | Olivia G Smith | Peer Specialist | 2201 Ironwood Pl Ste 100, Coeur D Alene, ID 83814-2670 | 2019-09-30 |
1477106037 | Brittni Hudlet | Peer Specialist | 2201 Ironwood Pl Ste 100, Coeur D Alene, ID 83814-2670 | 2019-07-22 |
1699332437 | Tiffany Stephenson | Peer Specialist | 2201 Ironwood Pl Ste 100, Coeur D Alene, ID 83814-2670 | 2019-05-28 |
1275010233 | Gordon Bruce Cuthbert | Peer Specialist | 2201 Ironwood Pl, Coeur D Alene, ID 83814-2670 | 2018-07-23 |
1679059208 | Tina Marie Rozniewski | Peer Specialist | 2201 Ironwood Pl, Coeur D Alene, ID 83814-2670 | 2018-07-17 |
1962988451 | Cassey Coleman | Peer Specialist | 2201 Ironwood Pl, Coeur D Alene, ID 83814-2670 | 2018-07-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639779523 | Tracie Lyn Hansen | Peer Specialist | 560 Fairway Dr, Pocatello, ID 83201-2012 | 2020-10-29 |
1306481817 | Ability Health and Rehabilitation LLC | Peer Specialist | 10101 W Overland Rd Ste 110, Boise, ID 83709-1429 | 2019-11-08 |
1609426923 | Amie Hughes | Peer Specialist | 4737 S Afton Pl Ste A, Chubbuck, ID 83202-2317 | 2019-09-18 |
1184113482 | Kolleen Marie Wynn-gallipeau | Peer Specialist | 444 Hospital Way Ste 447, Pocatello, ID 83201-2744 | 2018-05-02 |
1073127791 | Calm Waters Counseling Pllc | Peer Specialist | 10108 W Overland Rd Ste A, Boise, ID 83709-1428 | 2020-09-01 |
1790307890 | Jx2 LLC | Peer Specialist | 8950 W Emerald St Ste 178, Boise, ID 83704-8296 | 2020-05-12 |
1063034437 | Inroads, Inc | Peer Specialist | 3288 E Pine Ave, Meridian, ID 83642-5922 | 2020-05-08 |
1356962112 | Aaa American Healthcare LLC | Peer Specialist | 1301 E 17th St, Idaho Falls, ID 83404-6273 | 2020-05-04 |
1346878691 | Aspen Ministries Syringa Wellness | Peer Specialist | 1609 S Kimball Ave Ste 200, Caldwell, ID 83605-5196 | 2020-03-31 |
1356981419 | Lake City Counseling Center | Peer Specialist | 9705 N Shaw St, Hayden, ID 83835-9716 | 2020-01-07 |
Find all providers with the same taxonomy |
City | COEUR D ALENE |
Zip Code | 83814 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.