NPIMap

Organization Active NPI

Empowered Through Play LLC

  • Mental Health Counselor
  • Coeur d'Alene, ID
National Provider Identifier
1033588207
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
EMPOWERED THROUGH PLAY LLC
Practice address
560 W Canfield Ave
Ste 300
Coeur D Alene, ID 83815-7950
Phone
(208) 758-7111
NPI assigned
Sep 17, 2015
Last updated
Aug 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stacia Carr Peterson, LCPC
Title
Owner
Phone
(208) 758-7111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X ID Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

560 W Canfield Ave
Ste 300
Coeur D Alene, ID 83815-7950

Mailing address

560 W Canfield Ave
Ste 300
Coeur D Alene, ID 83815-7950
Phone (208) 758-7111

National Provider Directory

National Provider Directory

Locations

560 W Canfield Ave
Ste 300
Coeur D Alene, ID 83815
Phone (208) 758-7111

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471305600000",
    "number": "1033588207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W CANFIELD AVE",
            "address_2": "STE 300",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838157950",
            "telephone_number": "208-758-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W CANFIELD AVE",
            "address_2": "STE 300",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838157950",
            "telephone_number": "208-758-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWERED THROUGH PLAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-17",
        "last_updated": "2016-08-16",
        "status": "A",
        "authorized_official_last_name": "CARR PETERSON",
        "authorized_official_first_name": "STACIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-758-7111",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.