NPIMap

Organization Active NPI

Mental Wellness and Relationship Services LLC

Doing business as Mental Wellness and Relationship Services

  • Marriage & Family Therapist
  • Coeur d'Alene, ID
National Provider Identifier
1932773363
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
MENTAL WELLNESS AND RELATIONSHIP SERVICES LLC
Doing business as
Mental Wellness and Relationship Services
Practice address
1110 W Park PL Ste 303
Coeur D Alene, ID 83814-2784
Phone
(208) 283-8440
Fax
(208) 473-7271
NPI assigned
May 19, 2021
Last updated
Jul 26, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Authorized official

Name
Violet F Rudd, LMFTNPI 1598204190
Title
Co-Owner
Phone
(208) 283-8440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

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

Mailing address

1110 W Park PL Ste 303
Coeur D Alene, ID 83814-2784
Phone (208) 283-8440

Other names 1

  • Mental Wellness and Relationship Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211220002179 ID Part B Supplier - Clinic/Group Practice 5092106443 Receives reassigned benefits from 9 practitioners
Practice locations: Coeur D Alene, ID; Priest River, ID; Sandpoint, ID; Spirit Lake, ID

National Provider Directory

National Provider Directory

Locations

1110 W Park Pl
Ste 303
Coeur D Alene, ID 83814
Phone (208) 261-2255

1110 W Park Pl
Ste 320
Coeur D Alene, ID 83814
Phone (208) 261-2255

1200 W Ironwood Dr
Ste 306
Coeur D Alene, ID 83814
Phone (208) 651-1335

30410 Highway 200
Ste 200B
Ponderay, ID 83852

1033 Baldy Mountain Rd
Ste 103
Sandpoint, ID 83864
Phone (208) 261-2255

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658793600000",
    "number": "1932773363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W PARK PL STE 303",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142784",
            "telephone_number": "208-283-8440",
            "fax_number": "208-473-7271"
        },
        {
            "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": "208-283-8440",
            "fax_number": "208-473-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL WELLNESS AND RELATIONSHIP SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A",
        "authorized_official_last_name": "RUDD",
        "authorized_official_first_name": "VIOLET",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "208-283-8440",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mental Wellness and Relationship Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mental Wellness and Relationship Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.