| Mental Wellness Clinic Of Coeur D Alene Inc | |
|
1105 W Ironwood Dr Coeur D Alene ID 83814-2613 | |
| (208) 676-1003 | |
| (208) 676-1009 |
| Full Name | Mental Wellness Clinic Of Coeur D Alene Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1105 W Ironwood Dr, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Kelly Lagrou (OWNER PROGRAM MANAGER) |
| Authorized Official Contact | 2086761003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Wellness Clinic Of Coeur D Alene Inc 1105 W Ironwood Dr Coeur D Alene ID 83814-2613 Ph: (208) 676-1003 | Mental Wellness Clinic Of Coeur D Alene Inc 1105 W Ironwood Dr Coeur D Alene ID 83814-2613 Ph: (208) 676-1003 |
| NPI Number | 1871713925 |
|---|---|
| Provider Enumeration Date | 04/30/2007 |
| Last Update Date | 02/11/2025 |
| Certification Date | 02/11/2025 |
| Medicare PECOS PAC ID | 9537434014 |
|---|---|
| Medicare Enrollment ID | O20171130001622 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871713925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Barbara F Brinton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578642260 PECOS PAC ID: 9133222565 Enrollment ID: I20070305000780 |
| Provider Name | Fred M Itveldt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619393204 PECOS PAC ID: 4385867282 Enrollment ID: I20160630000068 |
| Provider Name | Kay Martens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538708862 PECOS PAC ID: 1254735954 Enrollment ID: I20210803000843 |
| Provider Name | Jason Kendall Pope |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558869909 PECOS PAC ID: 6406378470 Enrollment ID: I20250319001825 |
Ambitions Of Idaho, Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1044 Northwest Blvd Ste C, Coeur D Alene, ID 83814 Phone: 208-930-1740 Fax: 208-930-1695 | |
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 | |
Journey Counseling Of Coeur D'alene Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 Northwest Blvd Ste 101, Coeur D Alene, ID 83814 Phone: 208-953-1403 | |
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 | |
Line Of Courage Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 296 W Sunset Ave Ste 15, Coeur D Alene, ID 83815 Phone: 208-666-0357 | |
Trauma And Recovery Counseling Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 E Wallace Ave Ste B, Coeur D Alene, ID 83814 Phone: 801-885-0559 | |
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 |