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General NPI Number Information
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NPI Number | 1972042299
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Entity Type | Individual
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Provider Name | KARI THREADGILL MA, LMHCA, LPC, CMHS
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Gender | Female
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 250 NORTHWEST BLVD STE 107A
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2971
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Country | US
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Telephone | 208-449-1272
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Fax | 208-209-7427
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Provider Business Mailing Address
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Address Line | 2388 W DALTON AVE
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City | COEUR D ALENE
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State | ID
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Zip | 83815-0425
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MC 60590024
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License Number State | WA
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