Peach Counseling

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-29180 Issued in ID

Legal business name

PEACH COUNSELING

Practice address

2101 N Lakewood Dr
Suite 234
Coeur D Alene, ID 83814-2473

Phone

(208) 640-9257

NPI assigned

Feb 10, 2015

Organization subpart

No

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

Authorized official

Name

Sharene Heisler, LCSW

Title

Owner

Phone

(208) 640-9257

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480291200000",
    "number": "1053702142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 N LAKEWOOD DR",
            "address_2": "SUITE 234",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142473",
            "telephone_number": "208-640-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N LAKEWOOD DR",
            "address_2": "SUITE 234",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142473",
            "telephone_number": "208-640-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-10",
        "last_updated": "2016-11-28",
        "status": "A",
        "authorized_official_last_name": "HEISLER",
        "authorized_official_first_name": "SHARENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-640-9257",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-29180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWNER NPI#",
            "identifier": "1417079856",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurie Patterson, RD
• Kristin Michelle Paul, MD
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• Erik J Payne, M.D.
• Peaceful Haven Counseling, PLLC
• Jacob Scott Pearson, DO
• Kristen Leigh Pedersen, OTR/L
• Soren Pedersen
• Annaliese Elizabeth Pelletier, LCSW
• Courtney Alisha Pellow

• Clinical Social Worker in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.