Mark R Tetzlaff, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

2071065 Issued in ID

Practice address

1110 W Park PL Ste 303
Coeur D Alene, ID 83814-2784

Phone

(208) 261-2255

NPI assigned

May 26, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mental Wellness and Relationship Services LLC

  • Marriage & Family Therapist
  • Coeur D Alene, ID
  • NPI 1932773363
  NPD

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

{
    "created_epoch": "1748217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1629861406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3266 N 2ND ST",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838153760",
            "telephone_number": "208-500-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W PARK PL STE 303",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142784",
            "telephone_number": "208-261-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETZLAFF",
        "first_name": "MARK",
        "middle_name": "R",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-26",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "2071065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tesh, Inc.
• Tesh, Inc.
• Tesh, Inc.
• Tesh, Inc.
• Jamie Nichole Tesky, CNP
• Hunter Thacker
• The Gordian Mind
• The Love Factor, Inc.
• The MVMT Hub PLLC
• Theran Adamson, MD PLLC

• Social Worker in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.