NPIMap

Organization Active NPI

Wellness Enhancement Center of Idaho Inc.

Doing business as Psychiatry and Neurotherapy of Idaho

  • Community/Behavioral Health Agency
  • Coeur d'Alene, ID
National Provider Identifier
1417370990
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MHC-421 Issued in ID
Legal business name
WELLNESS ENHANCEMENT CENTER OF IDAHO INC.
Doing business as
Psychiatry and Neurotherapy of Idaho
Practice address
1111 W Ironwood Dr Ste B
Coeur D Alene, ID 83814-2604
Phone
(208) 664-1594
Fax
(208) 664-5867
NPI assigned
Feb 4, 2014
Last updated
May 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Mr. Robert Keith Wyatt, LCSWNPI 1093951915
Title
President
Phone
(208) 503-6298

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHC-421 ID Primary

Addresses

Primary practice location

1111 W Ironwood Dr Ste B
Coeur D Alene, ID 83814-2604

Mailing address

1111 W Ironwood Dr Ste B
Coeur D Alene, ID 83814-2604
Phone (208) 664-1594

Other identifiers 1

IdentifierTypeStateIssuer
807823900MedicaidID

Other names 1

  • Psychiatry and Neurotherapy of Idaho Doing business as

National Provider Directory

National Provider Directory

Locations

1111 W Ironwood Dr
#B
Coeur D Alene, ID 83814
Phone (208) 664-1594

950 W Ironwood Dr
Ste 2
Coeur D Alene, ID 83814
Phone (208) 664-1594

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1417370990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W IRONWOOD DR STE B",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142604",
            "telephone_number": "208-664-1594",
            "fax_number": "208-664-5867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W IRONWOOD DR STE B",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142604",
            "telephone_number": "208-664-1594",
            "fax_number": "208-664-5867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS ENHANCEMENT CENTER OF IDAHO INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-04",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-503-6298",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ID",
            "license": "MHC-421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807823900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychiatry and Neurotherapy of Idaho",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 1, 2025; 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.