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AMBITIONS OF IDAHO, INC.
NPI 1689133050
Clinic/Center - Mental Health (Including Community Mental Health Center) in Coeur D Alene, ID

Active since March 15, 2019
1044 NORTHWEST BLVD STE F, COEUR D ALENE, ID 83814(208) 676-9395(208) 676-9385 Get Directions Write a Review

NPPES record last updated: March 15, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ambitions Of Idaho, Inc. NPPES

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

AMBITIONS OF IDAHO, INC. (NPI 1689133050) 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 March 2019. The organization lists Shane Hagel, President, as its authorized official.

NPPES Registry Identity

NPI1689133050
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameAMBITIONS OF IDAHO, INC.
Location Address1044 NORTHWEST BLVD STE FCoeur D Alene, ID 83814-2165
Mailing Address1044 Northwest Blvd Ste FCoeur D Alene, ID 83814-2165 · (208) 676-9395 · Fax (208) 676-9385
Phone(208) 676-9395
Fax(208) 676-9385
Organization SubpartNo
Authorized OfficialShane HagelPresident · (208) 676-9395
Enumeration DateMarch 15, 2019
✔ NPI 1689133050 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
1044 NORTHWEST BLVD STE F, Coeur D Alene, ID 83814
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ambitions Of Idaho, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

9

Medicare enrollment records show 9 clinicians reassign Medicare billing to Ambitions Of Idaho, Inc., which bills Medicare for the services they deliver. Of these, 8 practice at this address. They are listed nearest first.

Clinicians, nearest first (9)

Melissa Alton, LCSW
Clinical Social Worker
NPI 1245764638
1044 NORTHWEST BLVD
Coeur D Alene, ID 83814
(208) 930-1740
✔ PECOS✔ Accepts MedicareSame address
Kelli Day
Mental Health Counselor
NPI 1942742309
1044 NORTHWEST BLVD STE C
Coeur D Alene, ID 83814
(208) 930-1740
✔ PECOS✔ Accepts MedicareSame address
Lara Gagne
Marriage and Family Therapist
NPI 1124170550
1044 NORTHWEST BLVD STE C
Coeur D Alene, ID 83814
(208) 930-1740
✔ PECOSSame address
Samuel Neal, LPC
Mental Health Counselor
NPI 1235510702
1044 NORTHWEST BLVD STE C
Coeur D Alene, ID 83814
(208) 930-1740
✔ PECOS✔ Accepts MedicareSame address
Jessica Peterson, LCSW
Clinical Social Worker
NPI 1669901260
1044 NORTHWEST BLVD STE C
Coeur D Alene, ID 83814
(208) 930-1740
✔ PECOS✔ Accepts MedicareSame address
Deborah Rodgers, LCSW
Clinical Social Worker
NPI 1760922470
1044 NORTHWEST BLVD STE C
Coeur D Alene, ID 83814
(208) 930-1740
✔ PECOSSame address
Tanya Ryan, LCSW
Clinical Social Worker
NPI 1225593288
1044 NORTHWEST BLVD STE C
Coeur D Alene, ID 83814
(208) 930-1740
✔ PECOS✔ Accepts MedicareSame address
Colleen Patterson
Mental Health Counselor
NPI 1770250201
1044 NORTHWEST BLVD STE C
Coeur D Alene, ID 83814
(208) 930-1740
✔ PECOS✔ Accepts MedicareSame address
Jeannie Dalton, LCSW
Clinical Social Worker
NPI 1316304678
23505 E APPLEWAY AVE STE 200 #200-1026
Liberty Lake, WA 99019
(509) 253-7834
✔ PECOS✔ Accepts Medicare

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Ambitions Of Idaho, Inc.'s NPI number?

The NPI number for Ambitions Of Idaho, Inc. is 1689133050. It was assigned to this organization in the NPPES registry on March 15, 2019.

Where is Ambitions Of Idaho, Inc. located?

Ambitions Of Idaho, Inc. is located at 1044 Northwest Blvd Ste F, Coeur D Alene, ID 83814. The listed phone number is (208) 676-9395.

What is Ambitions Of Idaho, Inc.'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.

Is Ambitions Of Idaho, Inc. enrolled in Medicare?

Yes. Ambitions Of Idaho, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ambitions Of Idaho, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 3 Medicare specialties reassign their Medicare billing to Ambitions Of Idaho, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (5), Mental Health Counselor (3) and Marriage and Family Therapist (1). Of these, 8 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Ambitions Of Idaho, Inc. was last updated on March 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.