Healthcare Provider Details

I. General information

NPI: 1982529772
Provider Name (Legal Business Name): BE WELL THERAPY GROUP OF IDAHO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1839 N GOVERNMENT WAY
COEUR D ALENE ID
83814-3454
US

IV. Provider business mailing address

4371 W MAGRATH DR
COEUR D ALENE ID
83815-0021
US

V. Phone/Fax

Practice location:
  • Phone: 208-797-1162
  • Fax: 208-625-2079
Mailing address:
  • Phone: 208-797-1162
  • Fax: 208-625-2079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. MELISA MAY MCTAGGERT STERNBERG
Title or Position: OWNER/PROVIDER
Credential: LCSW
Phone: 208-797-1162