FREDERICK J TIRRELL PHD PROFESSIONAL ASSOCIATION (NPI# 1013076215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013076215 |
| Entity Type | Organization |
| Organization Name | FREDERICK J TIRRELL PHD PROFESSIONAL ASSOCIATION |
| Other Organization Name | PROFESSIONAL ASSOCIATION |
| Practice Address |
3515 S 4th Street Leavenworth KS 66048 |
| Practice Telephone | 9136518415 |
| Practice Fax Number | 9137728580 |
| Mailing Telephone | 9136518415 |
| Mailing Fax Number | 9137728580 |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | WILLIAM ALBERT MOFFITT (VICE PRESIDENT OWNER) |
| Authorized Official Telephone | 9136518415 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | BCBS KANSAS | 004517 | 01 |
| KS | BCBS KANSAS CITY | 08422011 | 01 |
| Other Name | Type Code |
|---|---|
| Professional Association | Doing Business As Name - Organization |
| Street Address |
3515 S 4TH STREET |
| City | LEAVENWORTH |
| State | KS |
| Zip Code | 66048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417052614 | William Albert Moffitt | Psychologist | 3515 S 4th Street, Professional Association, Leavenworth, KS 66048 | 2006-09-13 |
| 1043381478 | Deborah Lynn Weidinger | Psychologist | 3515 S 4th Street, Professional Association, Leavenworth, KS 66048 | 2006-11-09 |
| 1770652281 | Steven Wright Nimrod | Counselor | 3515 S 4th Street, Professional Association, Leavenworth, KS 66048 | 2006-11-07 |
| 1053493189 | Susan Diane Nimrod | Counselor | 3515 S 4th Street, Professional Association, Leavenworth, KS 66048 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023653854 | Dawn Rishelle Hudson | Registered Nurse | 711 Marshall St., Leavenworth, KS 66048 | 2019-11-15 |
| 1427606706 | Nathan A Laskowski | Dentist | 3507 S 4th St. Trafficway, Leavenworth, KS 66048 | 2019-08-29 |
| 1386100220 | Aligned Health Chiropractic, LLC | Chiropractor | 402 Delware Street, Leavenworth, KS 66048 | 2019-02-15 |
| 1255805917 | Jordan Rachelle Kloepper | Chiropractor | 402 Delaware Street, Leavenworth, KS 66048 | 2019-01-16 |
| 1851862270 | Sarah Jane Wallace | Nurse Practitioner | Saint John Urgent Care, 3550 S 4th St, Ste B, Leavenworth, KS 66048 | 2018-12-11 |
| 1194222034 | Christie Ann Nelson | Psychologist | 4101 4th Street Trafficway, Leavenworth, KS 66048 | 2018-04-08 |
| 1558865782 | Sunflower Counseling Center LLC | Clinic/Center | 205 S 5th St Ste 15, Leavenworth, KS 66048 | 2018-03-21 |
| 1578062824 | Insoon G Hoagland | Marriage & Family Therapist | 205 S 5th St Ste 20, Leavenworth, KS 66048 | 2018-02-01 |
| 1467804542 | Raechel Marie Mackey | Nurse Practitioner | 4101 S 4th St Bldg 160, Leavenworth, KS 66048 | 2016-07-12 |
| 1073969598 | Kristen Simpson | Chiropractor | 211-b Delaware Street, Leavenworth, KS 66048 | 2016-05-13 |
| Find all providers in zip 66048 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194222034 | Christie Ann Nelson | Psychologist | 4101 4th Street Trafficway, Leavenworth, KS 66048 | 2018-04-08 |
| 1659640209 | Deborah L Weidinger Lmlp, Pa | Psychologist | 1301 S Broadway St, Leavenworth, KS 66048-3119 | 2011-12-27 |
| 1952530172 | Jessica Lynn Gustin | Psychologist | 4101 S. 4th St, Psychology Service (116b), Leavenworth, KS 66048 | 2009-07-09 |
| 1326265810 | Mary Banks Gregerson | Psychologist | 1116 S Esplanade St, Leavenworth, KS 66048-3522 | 2007-04-19 |
| 1801991195 | Gregory Timothy Ellermann | Psychologist | 3515 S 4th St, Professional Association, Leavenworth, KS 66048 | 2006-09-13 |
| 1417052614 | William Albert Moffitt | Psychologist | 3515 S 4th Street, Professional Association, Leavenworth, KS 66048 | 2006-09-13 |
| 1699723346 | Mary E Oehlert | Psychologist | 4101 S 4th St Trafficway, Leavenworth, KS 66048-5055 | 2006-05-05 |
| 1821577818 | Tracy O'connell Franklin | Psychologist | 4101 S 4th St, Leavenworth, KS 66048-5014 | 2018-08-09 |
| 1164909131 | David Friedlander | Psychologist | 500 Limit St, Leavenworth, KS 66048-4435 | 2018-07-23 |
| 1164965463 | Erin Elisabeth Mills | Psychologist | 4101 S 4th St, Leavenworth, KS 66048-5014 | 2016-11-18 |
| Find all providers in LEAVENWORTH | ||||
| City | LEAVENWORTH |
| Zip Code | 66048 |
Please comment or provide details below to improve the information on FREDERICK J TIRRELL PHD PROFESSIONAL ASSOCIATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.