NPI Code Details Logo

NPI 1295245793

NPI 1295245793 : LANA MOANA SCHUERMAN M.ED., ACADC : LEWISTON, ID

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1295245793
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    LANA MOANA SCHUERMAN M.ED., ACADC
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/10/2017
-----------------------------------------------------
    Last Update Date     |    04/15/2024
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2337 3RD AVE N 
-----------------------------------------------------
    City                 |    LEWISTON
-----------------------------------------------------
    State                |    ID
-----------------------------------------------------
    Zip                  |    83501-1625
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    509-444-8200
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    611 N IRON BRIDGE WAY 
-----------------------------------------------------
    City                 |    SPOKANE
-----------------------------------------------------
    State                |    WA
-----------------------------------------------------
    Zip                  |    99202-4932
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    509-444-8888
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    101YA0400X
-----------------------------------------------------
    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
    License Number       |    11626
-----------------------------------------------------
    License Number State |    ID
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    101Y00000X
-----------------------------------------------------
    Taxonomy Name        |    Counselor
-----------------------------------------------------
    License Number       |    LCPC-9690
-----------------------------------------------------
    License Number State |    ID
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.