NPIMap

Organization Active NPI

Canopy Village Inc.

  • Clinical Social Worker
  • Coeur D Alene, ID
National Provider Identifier
1609354109
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CANOPY VILLAGE INC.
Practice address
1350 W Hanley Ave
Coeur D Alene, ID 83815-8638
Phone
(208) 667-1189
NPI assigned
Aug 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Authorized official

Name
Rosa Anjelica MettlerNPI 1912185968
Title
Executive Director
Phone
(208) 667-1189

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1350 W Hanley Ave
Coeur D Alene, ID 83815-8638

Mailing address

1350 W Hanley Ave
Coeur D Alene, ID 83815-8638

Other practice location 1

1318 W Hanley Ave
Coeur D Alene, ID 83815-8638
Phone (208) 765-0688

National Provider Directory

National Provider Directory

Locations

1350 W Hanley Ave
Coeur D Alene, ID 83815
Phone (208) 667-1189

1318 W Hanley Ave
Coeur D Alene, ID 83815
Phone (208) 704-3849

Practitioners & affiliated clinicians

Practitioners 7

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": "1533513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768780800000",
    "number": "1609354109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 W HANLEY AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 W HANLEY AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158638",
            "telephone_number": "208-667-1189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1318 W Hanley Ave",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838158638",
            "country_code": "US",
            "telephone_number": "208-765-0688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CANOPY VILLAGE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-06",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A",
        "authorized_official_last_name": "METTLER",
        "authorized_official_first_name": "ROSA",
        "authorized_official_middle_name": "ANJELICA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "208-667-1189"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "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 Jan 19, 2026; 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.