Safe Waters Mental Recovery PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

W198609 Issued in ID

Legal business name

SAFE WATERS MENTAL RECOVERY PLLC

Practice address

2101 N Lakewood Dr Ste 226
Coeur D Alene, ID 83814-2473

Phone

(509) 559-4720

NPI assigned

Mar 30, 2018

Organization subpart

No

Name

Kathleen M Samsel, LCSW

Title

Owner

Phone

(509) 599-4720

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 30, 2018.

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522368000000",
    "number": "1992200901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 N LAKEWOOD DR STE 226",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142473",
            "telephone_number": "509-559-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 N LAKEWOOD DR STE 226",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142473",
            "telephone_number": "509-559-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE WATERS MENTAL RECOVERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-30",
        "last_updated": "2018-03-30",
        "status": "A",
        "authorized_official_last_name": "SAMSEL",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-599-4720",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "ID",
            "license": "W198609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Ryan, LCSW
• Thomas P Ryan, NP
• Aaron Sadowsky
• David Marshal Saelens, MPT
• Safe Harbor Counseling Center LLC
• Safeway Inc
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• Sage and Pine Counseling, LLC
• Linda M Sakai, MD
• Kaeleigh Salian

• All providers in Coeur D Alene, ID
• Mental Health Clinic/Center (Including Community Mental Health Center) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; 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.