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IDAHO DEPT OF HEALTH & WELFARE REG 1 AMH PSR CDA
NPI 1023145893
Clinic/Center - Mental Health (Including Community Mental Health Center) in Coeur D Alene, ID

Active since February 27, 2007
2195 IRONWOOD CT, COEUR D ALENE, ID 83814(208) 769-1406(208) 769-1430 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IDAHO DEPT OF HEALTH & WELFARE REG 1 AMH PSR CDA (NPI 1023145893) is a healthcare organization registered as a mental health (including community mental health center) in Coeur D Alene, Idaho and active in the NPI registry since February 2007. The organization lists Cora Jo Gussenhoven, Program Manager, as its authorized official.

NPPES Registry Identity

NPI1023145893
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameIDAHO DEPT OF HEALTH & WELFARE REG 1 AMH PSR CDA
Location Address2195 IRONWOOD CTCoeur D Alene, ID 83814-2628
Mailing Address2195 Ironwood CtCoeur D Alene, ID 83814-2628 · (208) 769-1406 · Fax (208) 769-1430
Phone(208) 769-1406
Fax(208) 769-1430
Organization SubpartNo
Authorized OfficialCora Jo GussenhovenProgram Manager · (208) 769-1406
Enumeration DateFebruary 27, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1023145893 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
2195 IRONWOOD CT, Coeur D Alene, ID 83814
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Other Identifiers 3

Medicaid0028407ID
Other000010018348Blue Shield
OtherHW256Blue Cross Of Idaho

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KELLI JO MCKEE
Developmental Therapist
2195 IRONWOOD CT
COEUR D ALENE, ID 83814
Kootenai County (208) 769-2708
BRIANNA WATTS DS
Developmental Therapist
2195 IRONWOOD CT
COEUR D ALENE, ID 83814
Kootenai County (208) 769-2710
SHARMA LEIGH WALKER-THORNTON LPC
Counselor
2195 IRONWOOD CT
COEUR D ALENE, ID 83814
Kootenai County (208) 769-1406
RICHARD LEE PERRY NURSE PRACTITIONER
Nurse Practitioner (Psychiatric/Mental Health)
2195 IRONWOOD CT
COEUR D ALENE, ID 83814
Kootenai County (208) 769-1406
LAURIE GALLEGOS PA-C
Physician Assistant
2195 IRONWOOD CT
COEUR D ALENE, ID 83814
Kootenai County (208) 769-1406
TED WARSTADT
Counselor (Mental Health)
2195 IRONWOOD CT
COEUR D ALENE, ID 83814
Kootenai County (208) 769-1406
JAMIE ARBOGAST LCSW
Social Worker (Clinical)
2195 IRONWOOD CT
COEUR D ALENE, ID 83814
Kootenai County (208) 769-1406
BREANNA AMMARI
Developmental Therapist
2195 IRONWOOD CT
COEUR D ALENE, ID 83814
Kootenai County (208) 769-1409

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda's NPI number?

The NPI number for Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda is 1023145893. It was assigned to this organization in the NPPES registry on February 27, 2007.

Where is Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda located?

Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda is located at 2195 Ironwood Ct, Coeur D Alene, ID 83814. The listed phone number is (208) 769-1406.

What is Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.