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 |
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Medicare Enrollment ID | O20170314000619 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003145533 | NPI | - | NPPES |
8079051 | Medicaid | ID |
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 | 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 | |
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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 | |
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 | |
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 |