| Ambitions | |
|
1044 Northwest Blvd Ste C Coeur D Alene ID 83814-2114 | |
| (208) 930-1740 | |
| (208) 930-1695 |
| Full Name | Ambitions |
|---|---|
| Speciality | Clinic/Center |
| Location | 1044 Northwest Blvd Ste C, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Shane Hagel (PRESIDENT) |
| Authorized Official Contact | 2089301740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ambitions 1044 Northwest Blvd Ste C Coeur D Alene ID 83814-2114 Ph: (208) 930-1740 | Ambitions 1044 Northwest Blvd Ste C Coeur D Alene ID 83814-2114 Ph: (208) 930-1740 |
| NPI Number | 1003145533 |
|---|---|
| Provider Enumeration Date | 12/11/2009 |
| Last Update Date | 10/12/2023 |
| Certification Date | 10/12/2023 |
| Medicare PECOS PAC ID | 6305121328 |
|---|---|
| Medicare Enrollment ID | O20170314000619 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003145533 | NPI | - | NPPES |
| 8079051 | Medicaid | ID |
| Provider Name | Ryan J Hulbert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053689356 PECOS PAC ID: 0042470031 Enrollment ID: I20120328001061 |
| Provider Name | James J Cruzen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740400514 PECOS PAC ID: 9436309531 Enrollment ID: I20121026000209 |
| Provider Name | Shannon Denisce Andrews |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477009041 PECOS PAC ID: 7911295175 Enrollment ID: I20161004002253 |
| Provider Name | Deborah E Rodgers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760922470 PECOS PAC ID: 2961776547 Enrollment ID: I20170920002102 |
| Provider Name | Jeannie Dalton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316304678 PECOS PAC ID: 5698023984 Enrollment ID: I20180802001585 |
| Provider Name | Angel M Ford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114307626 PECOS PAC ID: 6204184971 Enrollment ID: I20180813002116 |
| Provider Name | Eileen Mcdermott Ganong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285084541 PECOS PAC ID: 7315373750 Enrollment ID: I20200204000943 |
| Provider Name | Kari Kristin Benton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962664805 PECOS PAC ID: 9537583190 Enrollment ID: I20200716000751 |
| Provider Name | Jessica Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669901260 PECOS PAC ID: 4688082787 Enrollment ID: I20210408002075 |
| Provider Name | Melissa Alton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245764638 PECOS PAC ID: 2961810585 Enrollment ID: I20230213001263 |
| Provider Name | Tanya Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225593288 PECOS PAC ID: 3779938337 Enrollment ID: I20231017002440 |
| Provider Name | Colleen Kay Patterson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770250201 PECOS PAC ID: 0648621672 Enrollment ID: I20240103004816 |
| Provider Name | Samuel Neal |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235510702 PECOS PAC ID: 3173975984 Enrollment ID: I20240117002993 |
| Provider Name | Michael Georgescu |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639629132 PECOS PAC ID: 1153773726 Enrollment ID: I20240118004069 |
| Provider Name | Lara Patrice Gagne |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1124170550 PECOS PAC ID: 5991158412 Enrollment ID: I20240131001616 |
| Provider Name | Kelli Day |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942742309 PECOS PAC ID: 5092150318 Enrollment ID: I20240227001026 |
Restored Paths Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 E Harrison Ave, Coeur D Alene, ID 83814 Phone: 208-664-8347 | |
Cooksey Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 Northwest Blvd Ste 107a, Coeur D Alene, ID 83814 Phone: 208-551-5158 | |
Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2195 Ironwood Ct, Coeur D Alene, ID 83814 Phone: 208-769-1406 Fax: 208-769-1430 | |
North Lakes Family Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 E Lakeside Ave, Coeur D Alene, ID 83814 Phone: 208-664-5941 | |
Mental Wellness Centers Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 N Government Way Ste 100, Coeur D Alene, ID 83814 Phone: 208-676-1003 Fax: 208-676-1009 | |
Empowered Through Play Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 560 W Canfield Ave, Ste 300, Coeur D Alene, ID 83815 Phone: 208-758-7111 |