NPIMap

Individual provider Active NPI

Jeremy Kendall, LPC, QMHP, LAC

  • Mental Health Counselor
  • Coeur D Alene, ID
National Provider Identifier
1770961500
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3700 W Seltice Way
Coeur D Alene, ID 83814-8921
Phone
(208) 620-5255
NPI assigned
May 13, 2015
Sex
Male
Sole proprietor
No

Organizations & group practices 14

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.

View all 14

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dirne Health Centers Inc 82 clinicians

Practice addresses (Care Compare)

3700 W Seltice Way
Coeur D Alene, ID 83814-8921
Phone (208) 620-5255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241031003086 ID Practitioner - Mental Health Counselor 0749632875 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCPC-9460IDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dirne Health Centers Inc Counselor CurrentSince Jan 1, 2024 Accepting new patients
Dirne Health Centers, Inc. Counselor CurrentSince Jan 1, 2024 Accepting new patients
Dirne Health Centers, Inc. Counselor Current Accepting new patients
Addiction Recovery Centers of the Black Hills PastSince Jul 5, 2024 Accepting new patients
Dirne Health Centers Inc Counselor PastSince Jun 1, 2023 Accepting new patients
Stephen Tamang MD Consulting Services PC PastSince Oct 10, 2018 Accepting new patients

Locations

3700 W Seltice Way
Coeur D Alene, ID 83814
Phone (208) 620-5250

2205 N Ironwood Pl
Coeur D Alene, ID 83814
Phone (208) 292-0303

1090 W Park Pl
Coeur D Alene, ID 83814
Phone (208) 215-2005

740 McKinley Ave
Kellogg, ID 83837
Phone (208) 783-1267

925 E Polston Ave
Post Falls, ID 83854
Phone (208) 618-0787

16760 N Highway 41
Rathdrum, ID 83858
Phone (208) 687-5627

120 S 13th St
St Maries, ID 83861
Phone (208) 245-4363

Interoperability endpoints

  • Direct secure messaging: jeremy.kendall.1@16899.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/18632/brand/1/csg/1/fhir/r4

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LCPC-9460 ID
Mental Health Counselor 101YM0800X Primary

Addresses

NPPES NPI Registry

Primary practice location

3700 W Seltice Way
Coeur D Alene, ID 83814-8921

Mailing address

PO Box 1387
Hayden, ID 83835-1387
Phone (208) 415-0299

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 4, 2025.

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1770961500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1387",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838351387",
            "telephone_number": "208-415-0299",
            "fax_number": "605-718-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 W SELTICE WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838148921",
            "telephone_number": "208-620-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDALL",
        "first_name": "JEREMY",
        "credential": "LPC, QMHP, LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-13",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LCPC-9460",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.