NPIMap

Organization Active NPI

Porto Uniao, Inc

Doing business as Pain Management Psychology

  • Community/Behavioral Health Agency
  • Coeur d'Alene, ID
National Provider Identifier
1972774602
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
202060 Issued in ID
Legal business name
PORTO UNIAO, INC
Doing business as
Pain Management Psychology
Practice address
2180 W Ironwood Center Dr
Coeur D Alene, ID 83814-2639
Phone
(208) 676-0926
Fax
(208) 772-5969
NPI assigned
Mar 20, 2008
Last updated
Jun 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Authorized official

Name
Dr. Laverl H. Wilhelm, PHD
Title
Psychologist
Phone
(208) 676-0926

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 202060 ID Primary

Addresses

Primary practice location

2180 W Ironwood Center Dr
Coeur D Alene, ID 83814-2639

Mailing address

212 W Ironwood Dr Ste D311
Coeur D Alene, ID 83814-1403
Phone (208) 676-0926

Other names 1

  • Pain Management Psychology Doing business as

National Provider Directory

National Provider Directory

Locations

212 W Ironwood Dr
#D3111
Coeur D Alene, ID 83814

212 W Ironwood Dr
Ste D311
Coeur D Alene, ID 83814

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1972774602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 W IRONWOOD DR STE D311",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838141403",
            "telephone_number": "208-676-0926",
            "fax_number": "208-772-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 W IRONWOOD CENTER DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142639",
            "telephone_number": "208-676-0926",
            "fax_number": "208-772-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTO UNIAO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "WILHELM",
        "authorized_official_first_name": "LAVERL",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "208-676-0926",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ID",
            "license": "202060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Management Psychology",
            "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 Jun 10, 2008; 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.