Provider Demographics
NPI:1003633041
Name:JOURNEY COUNSELING OF COEUR D'ALENE
Entity type:Organization
Organization Name:JOURNEY COUNSELING OF COEUR D'ALENE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR AND ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:ASHLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:UNRUH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC
Authorized Official - Phone:208-953-1403
Mailing Address - Street 1:250 NORTHWEST BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2974
Mailing Address - Country:US
Mailing Address - Phone:208-953-1403
Mailing Address - Fax:
Practice Address - Street 1:250 NORTHWEST BLVD STE 101
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2974
Practice Address - Country:US
Practice Address - Phone:208-953-1403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty