Resilience Psychiatric Medicine

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

RESILIENCE PSYCHIATRIC MEDICINE

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

May 9, 2014

Organization subpart

No

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

Authorized official

Name

Nicole Carlberg, DO

Title

Owner

Phone

(208) 292-2218

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1399593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577059200000",
    "number": "1760893945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3727",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838162529",
            "telephone_number": "208-292-2188",
            "fax_number": "208-292-2189"
        },
        {
            "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": "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"
        },
        {
            "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",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RESILIENCE PSYCHIATRIC MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-09",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A",
        "authorized_official_last_name": "CARLBERG",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-292-2218",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Dec 23, 2019; 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.