Active NPI
Jacob Schroeder
- Professional Counselor
- Coeur d'Alene, ID
National Provider Identifier
1255240453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 7081036
- Practice address
- 3700 W Seltice Way
Coeur D Alene, ID 83814-8921 - Phone
- (208) 620-5210
- NPI assigned
- Sep 3, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 7081036 | ID | |
| Mental Health Counselor | 101YM0800X | 7081036 | ID | |
| Professional Counselor | 101YP2500X | 7081036 | ID | Primary |
Addresses
Primary practice location
3700 W Seltice Way
Coeur D Alene, ID 83814-8921
Mailing address
3700 W Seltice Way
Coeur D Alene, ID 83814-8921
Phone (208) 620-5210
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788393600000",
"number": "1255240453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3700 W SELTICE WAY",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838148921",
"telephone_number": "208-620-5210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 W SELTICE WAY",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838148921",
"telephone_number": "208-620-5210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHROEDER",
"first_name": "JACOB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-09-03",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "ID",
"license": "7081036",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "7081036",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "7081036",
"primary": true
}
],
"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 Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.