Iron Roots Recovery & Mental Wellness, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

IRON ROOTS RECOVERY & MENTAL WELLNESS, LLC

Practice address

2025 W Park PL Ste 105
Coeur D Alene, ID 83814-2787

Phone

(208) 659-2049

Fax

(208) 719-7952

NPI assigned

Mar 18, 2025

Organization subpart

No

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

Authorized official

Name

Jennifer Marie Mayberry, LMSWNPI 1134994858

Title

Owner

Phone

(208) 771-7013

Specialties & licenses 5

Addresses

Other names 1

• Iron Roots Recovery & Mental Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tabitha R Day, LMSW

  • Social Worker
  • Coeur D Alene, ID
  • NPI 1629638846

  ID

  Medicare reassignment Care Compare group NPD
• Angela M Van Zandt, LCSW

  • Clinical Social Worker
  • Coeur D Alene, ID
  • NPI 1649521162

  ID

  Medicare reassignment Care Compare group NPD
• Jennifer Marie Mayberry, L.M.S.W.

  • Mental Health Counselor
  • Coeur D Alene, ID
  • NPI 1134994858

  Mental Health

  NPD Authorized official
• Jason Adams

  • Addiction (Substance Use Disorder) Counselor
  • Coeur D Alene, ID
  • NPI 1306274055
  Care Compare group
• Carol Jean Baker

  • Mental Health Counselor
  • Coeur D Alene, ID
  • NPI 1326966169

  Mental Health

  NPD (past)
• Geri Lea Cribbs, PHD

  • Clinical Psychologist
  • Post Falls, ID
  • NPI 1144030834
  NPD (past)

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782518400000",
    "number": "1104626944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 W PARK PL STE 105",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142787",
            "telephone_number": "208-771-7013",
            "fax_number": "208-719-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 W PARK PL STE 105",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142787",
            "telephone_number": "208-659-2049",
            "fax_number": "208-719-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRON ROOTS RECOVERY & MENTAL WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-18",
        "last_updated": "2026-06-27",
        "certification_date": "2026-06-27",
        "status": "A",
        "authorized_official_last_name": "MAYBERRY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-771-7013",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Iron Roots Recovery & Mental Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Iron Roots Recovery & Mental Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Coeur D Alene, ID
• Mental Health Clinic/Center (Including Community Mental Health Center) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.