{
"Npi": {
"NPI": "1215365523",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TAMARACK TREATMENT AND COUNSELING CENTER, PLLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "710 W SUPERIOR ST STE C",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SANDPOINT",
"MailingAddressStateName": "ID",
"MailingAddressPostalCode": "83864-1684",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "208-263-5551",
"MailingAddressFaxNumber": "208-255-4476",
"FirstLinePracticeLocationAddress": "710 W SUPERIOR ST STE C",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SANDPOINT",
"PracticeLocationAddressStateName": "ID",
"PracticeLocationAddressPostalCode": "83864-1684",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "208-263-5551",
"PracticeLocationAddressFaxNumber": "208-255-4476",
"EnumerationDate": "10/23/2013",
"LastUpdateDate": "10/27/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STEVENS",
"AuthorizedOfficialFirstName": "JANICE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "208-263-5551",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "LCPC-4183",
"LicenseNumberStateCode": "ID",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}