NPIMap

Organization Active NPI

Sage and Pine Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Coeur D Alene, ID
National Provider Identifier
1558049155
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SAGE AND PINE COUNSELING, LLC
Practice address
1042 W Mill Ave Ste 103
Coeur D Alene, ID 83814-2489
Phone
(208) 405-0260
NPI assigned
Jul 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Authorized official

Name
Karissa Kimes, LAMFTNPI 1396406211
Title
Owner and Practitioner
Phone
(208) 699-3667

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
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1042 W Mill Ave Ste 103
Coeur D Alene, ID 83814-2489

Mailing address

1042 W Mill Ave Ste 103
Coeur D Alene, ID 83814-2489
Phone (208) 405-0260

National Provider Directory

National Provider Directory

Locations

1042 W Mill Ave
Ste 103
Coeur D Alene, ID 83814
Phone (208) 405-0260

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1558049155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 W MILL AVE STE 103",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142489",
            "telephone_number": "208-405-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 W MILL AVE STE 103",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142489",
            "telephone_number": "208-405-0260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE AND PINE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A",
        "authorized_official_last_name": "KIMES",
        "authorized_official_first_name": "KARISSA",
        "authorized_official_title_or_position": "OWNER AND PRACTITIONER",
        "authorized_official_telephone_number": "208-699-3667",
        "authorized_official_credential": "LAMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "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 Jul 5, 2023; 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.