Nicole L Carlberg, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ID-O-0592 Issued in ID

Practice address

2426 N Merritt Creek Loop Ste a
Coeur D Alene, ID 83814-4961

Phone

(208) 668-7000

Fax

(208) 665-9879

NPI assigned

Aug 1, 2006

Sex

Female

Sole proprietor

Yes

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)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1730196056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2426 N MERRITT CREEK LOOP",
            "address_2": "STE A",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144961",
            "telephone_number": "208-668-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2426 N MERRITT CREEK LOOP STE A",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144961",
            "telephone_number": "208-668-7000",
            "fax_number": "208-665-9879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1417 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838143310",
            "country_code": "US",
            "telephone_number": "208-292-2188 x122",
            "fax_number": "208-292-2189",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "213 N Main St Unit B",
            "address_purpose": "LOCATION",
            "city": "Moscow",
            "state": "ID",
            "postal_code": "838432700",
            "country_code": "US",
            "telephone_number": "208-668-7000",
            "fax_number": "208-665-9879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLBERG",
        "first_name": "NICOLE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "ID-O-0592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Hughes Cardarelli, M.D.
• Deborah Christina Carder, LCSW-42229
• Care Planning Institute, Inc
• Nicholas Carey, MD
• Michael Carl, M.D.
• Holly Anne Carling, O.M.D., L.AC., PH.D.
• Jacquelynne Rose Carlson
• Mellisa Ann Carlson, LCSW
• Tonya Carlson
• Ruben Carmona

• Psychiatry Physician in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Psychiatry Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; 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.