OrganizationActive
Living Waters Coordinated Communities, Inc.
NPI 1215153432 · Pain Clinic/Center · Coeur D Alene, ID
Provider details
- NPI number
- 1215153432
- Entity type
- Organization
- Primary specialty
- Pain Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Laverl Wilhelm, President, Psychologist(208) 676-0926
- License
- PSYCHOLOGY 202060 (ID)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2108 N Ironwood Center Dr
Coeur D Alene, ID 83814
Phone: (208) 676-0926
Fax: (208) 676-0926
Approximate (ZIP-level) locationGet directions
Mailing address
212 W Ironwood Dr
Coeur D Alene, ID 83814-1403
Other names (DBA / former)
- Doing business as
- Pain Management Psychology
Registry dates
- Enumerated
- 2007-04-17
- Last updated
- 2007-09-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.