| Jeremy Kendall, LPC, QMHP, LAC | |
|
6795 N Mineral Dr, Coeur D Alene, ID 83815-8700 | |
| (208) 415-0299 | |
| Not Available |
| Full Name | Jeremy Kendall |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 6795 N Mineral Dr, Coeur D Alene, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770961500 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LCPC-9460 (Idaho) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Entity Name | Dirne Health Centers, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285686477 PECOS PAC ID: 2466353354 Enrollment ID: O20050303001041 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeremy Kendall, LPC, QMHP, LAC Po Box 1387, Hayden, ID 83835-1387 Ph: (208) 415-0299 | Jeremy Kendall, LPC, QMHP, LAC 6795 N Mineral Dr, Coeur D Alene, ID 83815-8700 Ph: (208) 415-0299 |
Joshua Michael Raybell, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2005 N Ironwood Pkwy Ste 222, Coeur D Alene, ID 83814 Phone: 208-964-6510 | |
Dr. Billie Jo Davis, PH.D., BCBA Counselor Medicare: Not Enrolled in Medicare Practice Location: 21 Ironwood Dr., Suite D Pmd 106, Coeur D Alene, ID 83815 Phone: 208-699-2595 | |
Mrs. Jacqueline Lee Butera, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1200 W Ironwood Dr, Suite 101, Coeur D Alene, ID 83814 Phone: 208-664-9729 Fax: 208-263-7515 | |
Mrs. Danielle Nichole Kisler, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7905 N Meadowlark Way, Ste A And B, Coeur D Alene, ID 83815 Phone: 208-691-2048 | |
Haley Scott, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2101 N Lakewood Dr Ste 225, Coeur D Alene, ID 83814 Phone: 775-224-4996 | |
Mr. Gregory Raymond Lee, L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1200 W Ironwood Dr, Suite 101, Coeur D Alene, ID 83814 Phone: 208-664-9729 | |
Ms. Jodi Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2201 Ironwood Pl, Coeur D Alene, ID 83814 Phone: 208-769-4222 Fax: 208-667-7557 |