Healthcare Provider Details

I. General information

NPI: 1427822485
Provider Name (Legal Business Name): WESTWIND WELLNESS CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2023
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 N 3RD ST STE 200
COEUR D ALENE ID
83814-3400
US

IV. Provider business mailing address

1801 N 3RD ST STE 200
COEUR D ALENE ID
83814-3400
US

V. Phone/Fax

Practice location:
  • Phone: 208-261-1158
  • Fax: 208-900-6383
Mailing address:
  • Phone: 208-261-1158
  • Fax: 208-900-6383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSHUA T WESTBY
Title or Position: FOUNDER
Credential: DSW, LCSW, ASDCS
Phone: 480-383-9149