Individual provider Active NPI

Michael Georgescu

  • Social Worker
  • Coeur D Alene, ID
National Provider Identifier
1639629132
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LMSW-35360 Issued in ID
Practice address
1044 Northwest Blvd Ste C
Coeur D Alene, ID 83814-2114
Phone
(208) 930-1740
Fax
(208) 930-1695
NPI assigned
Oct 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LMSW-35360 ID
Social Worker 104100000X LMSW-35360 ID Primary

Addresses

Primary practice location

1044 Northwest Blvd Ste C
Coeur D Alene, ID 83814-2114

Mailing address

1200 W Ironwood Dr Ste 101
Coeur D Alene, ID 83814-2660

Other practice location 1

1200 W Ironwood Dr Ste 101
Coeur D Alene, ID 83814-2660
Phone (208) 664-9729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35360IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ambitions of Idaho, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Ambitions of Idaho, Inc Clinical CurrentSince Jan 1, 2024 Accepting new patients

Locations

1044 Northwest Blvd
Ste C
Coeur D Alene, ID 83814
Phone (208) 667-7777

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1639629132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W IRONWOOD DR STE 101",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 NORTHWEST BLVD STE C",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142114",
            "telephone_number": "208-930-1740",
            "fax_number": "208-930-1695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 W Ironwood Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142660",
            "country_code": "US",
            "telephone_number": "208-664-9729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGESCU",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-07",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LMSW-35360",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-35360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.