Provider Demographics
NPI:1235851445
Name:STABILITY MENTAL HEALTH, PLLC
Entity Type:Organization
Organization Name:STABILITY MENTAL HEALTH, PLLC
Other - Org Name:STABILITY MENTAL HEALTH, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:509-361-5154
Mailing Address - Street 1:409 E COEUR D ALENE AVE STE 21
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2877
Mailing Address - Country:US
Mailing Address - Phone:509-361-5154
Mailing Address - Fax:509-361-5154
Practice Address - Street 1:409 E COEUR D ALENE AVE STE 21
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2877
Practice Address - Country:US
Practice Address - Phone:509-361-5154
Practice Address - Fax:509-361-5154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID2022059071OtherANCC CERTIFICATION
ID73849OtherID APRN
WAAP61350441OtherWASHINGTON APRN
1972258671OtherNPI
IDMP7620455OtherID DEA
1972258671OtherNPI