Healthcare Provider Details

I. General information

NPI: 1609739234
Provider Name (Legal Business Name): 222 ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

693 W CANFIELD AVE
COEUR D ALENE ID
83815-5239
US

IV. Provider business mailing address

1208 E PENNSYLVANIA AVE
COEUR D ALENE ID
83814-4343
US

V. Phone/Fax

Practice location:
  • Phone: 888-208-0559
  • Fax:
Mailing address:
  • Phone: 888-208-0559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN MCMURRAY
Title or Position: COUNSELOR/COACH
Credential: BCMHC/COUNSELOR
Phone: 888-208-0559