IDAHO DEPT OF HEALTH & WELFARE REG 1 AMH CLINIC CDA (NPI# 1831226547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831226547 |
| Entity Type | Organization |
| Organization Name | IDAHO DEPT OF HEALTH & WELFARE REG 1 AMH CLINIC CDA |
| Practice Address |
2195 Ironwood Ct Coeur D Alene ID 83814-2628 |
| Practice Telephone | 2087691406 |
| Practice Fax Number | 2087691430 |
| Mailing Telephone | 2087691406 |
| Mailing Fax Number | 2087691430 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CORA JO GUSSENHOVEN (PROGRAM MANAGER) |
| Authorized Official Telephone | 2087691406 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE SHIELD | 000010018348 | 01 | |
| BLUE CROSS OF IDAHO | HW256 | 01 | |
| ID | 8073574 | 05 |
| Street Address |
2195 IRONWOOD CT |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-2628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215926258 | Laurie Gallegos | Physician Assistant | 2195 Ironwood Ct, Coeur D Alene, ID 83814-2628 | 2005-10-20 |
| 1871118752 | Alissa M Rice | Social Worker | 2195 Ironwood Ct, Coeur D Alene, ID 83814-2624 | 2020-06-16 |
| 1114575958 | Sharma Leigh Walker-thornton | Counselor | 2195 Ironwood Ct, Coeur D Alene, ID 83814-2624 | 2019-08-26 |
| 1295201663 | Vallenthia Ann Johnson | Social Worker | 2195 Ironwood Ct, Coeur D Alene, ID 83814-2624 | 2018-10-23 |
| 1740765528 | Kelly Jean Rhoads | Social Worker | 2195 Ironwood Ct, Coeur D Alene, ID 83814-2624 | 2018-09-27 |
| 1083136774 | Brianna Watts | Developmental Therapist | 2195 Ironwood Ct, Coeur D Alene, ID 83814-2624 | 2017-07-13 |
| 1164976114 | Devona Marie Mahal | Marriage & Family Therapist | 2195 Ironwood Ct, Coeur D Alene, ID 83814-2624 | 2016-08-08 |
| 1528417839 | Tracy Rudd-heilig | Social Worker | 2195 Ironwood Ct, Coeur D Alene, ID 83814-2624 | 2016-06-07 |
| 1053775320 | Linda Hill | Counselor | 2195 Ironwood Ct, Coeur D Alene, ID 83814-2628 | 2016-04-12 |
| 1760846430 | Robert Michael Wraith I | Social Worker | 2195 Ironwood Ct, Coeur D Alene, ID 83814-2624 | 2016-04-08 |
| Find all providers in the same location | ||||
| 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 | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700394822 | Lookout Behavioral Health LLC | Clinic/Center | 7905 N Meadowlark Way Ste A, Coeur D Alene, ID 83815-5041 | 2018-01-11 |
| 1447695630 | Susan M. Beglinger, Ltd | Clinic/Center | 206 E Indiana Ave, Suite 112, Coeur D Alene, ID 83814-2969 | 2013-05-01 |
| 1518592344 | Crescent Moon Counseling, LLC | Clinic/Center | 1055 E Timber Ln, Coeur D Alene, ID 83815-6508 | 2020-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942808019 | Helping Hearts Counseling Center, Pllc | Clinic/Center | 310 Cleveland Blvd, Caldwell, ID 83605-3624 | 2020-10-12 |
| 1811502438 | Dale Wilson Counseling and Evaluation | Clinic/Center | 6126 W State St Ste 101, Boise, ID 83703-2741 | 2020-09-10 |
| 1144843285 | Whole Health Counseling LLC | Clinic/Center | 2616 W Jefferson St, Boise, ID 83702-4713 | 2020-05-23 |
| 1033740865 | Jackie Nelson, Pllc | Clinic/Center | 202 N 9th St Ste 401c, Boise, ID 83702-5770 | 2020-01-30 |
| 1437621646 | Joanne Burgio Phd LLC | Clinic/Center | 3061 S Meridian Rd Ste 150, Meridian, ID 83642-7962 | 2018-12-28 |
| 1346759495 | Pacific Mind Institute | Clinic/Center | 2596 N Stokesberry Pl Ste 165, Meridian, ID 83646-6281 | 2017-09-20 |
| 1336599976 | Easy Go Express | Clinic/Center | 3551 W Antelope Rd, Moore, ID 83255-8754 | 2016-06-14 |
| 1669808614 | Integrated Interventions LLC | Clinic/Center | 2482 E. Glacier Rd., Hayden Lake, ID 83835 | 2013-09-23 |
| 1750621116 | New Horizons Mental Wellness Clinics | Clinic/Center | 1352 E. Center, Suite A, Pocatello, ID 83201-4773 | 2013-02-22 |
| 1518217983 | Aspenwood Counseling and Behavior Center | Clinic/Center | 225 South Street, Albion, ID 83311-0111 | 2012-09-13 |
| Find all providers with the same taxonomy | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
Please comment or provide details below to improve the information on IDAHO DEPT OF HEALTH & WELFARE REG 1 AMH CLINIC CDA.
| 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.