MS. CHERYL ANN RENZULLI (NPI# 1093255242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093255242 |
| Entity Type | Individual |
| Full Name | MS. CHERYL ANN RENZULLI |
| Credential | MA, LAT |
| Practice Address |
1115 Maple Way Suite C Jackson WY 83001-8567 |
| Mailing Address |
Po Box 9615 Jackson WY 83002-9615 |
| Practice Telephone | 3076990807 |
| Practice Fax Number | 3077337339 |
| Mailing Telephone | 3076990807 |
| Mailing Fax Number | 3077337339 |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LAT #324 | WY | Behavioral Health & Social Service Providers |
| Street Address |
1115 MAPLE WAY SUITE C |
| City | JACKSON |
| State | WY |
| Zip Code | 83001-8567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538211388 | Steven Andrew Nelson | Psychologist | 1115 Maple Way, Suite D, Jackson, WY 83001-8567 | 2007-01-18 |
| 1881971679 | Kurt Lower Linford | Dentist | 1115 Maple Way, Jackson, WY 83001-8634 | 2011-11-08 |
| 1134364094 | Stephen Stuart Lottridge | Psychologist | 1115 Maple Way, Suite D, Jackson, WY 83002-7411 | 2008-12-08 |
| 1033235379 | Veldon Ross Moser | Dentist | 1115 Maple Way, Jackson, WY 83001 | 2007-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861006108 | Anne Kathleen Milburn | Physical Therapist | 3620 S Park Drive, Jackson, WY 83001 | 2020-09-03 |
| 1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
| 1043878408 | Cossette Burnham | Physical Therapist | Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 | 2019-05-31 |
| 1982169371 | Cynthia Buck Huyffer | Social Worker | 755a Cache Creek Drive, Jackson, WY 83001 | 2019-02-10 |
| 1093281594 | Lara Cilo | Speech-Language Pathologist | 1300 W. Valley Springs Road, Jackson, WY 83001 | 2018-10-23 |
| 1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
| 1437642055 | Anna Yanchek | Physical Therapist | 1090 Us- 89, Jackson Hole, WY 83001 | 2018-06-08 |
| 1891200762 | Tyler Ross Wright | Chiropractor | 1325 Us-89, Suite 108, Jackson, WY 83001 | 2017-12-13 |
| 1073027280 | Root To Rise Counseling and Consulting, Pllc | Social Worker | 2033 Dandelion Court, Jackson, WY 83001 | 2017-11-27 |
| 1962923912 | Piper Worthington | Social Worker | 1910 High School Rd, Jackson, WY 83001 | 2017-06-29 |
| Find all providers in zip 83001 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457952665 | John Cate Owen | Counselor | 2525 Lakeward Dr Ste 400, Jackson, MS 39216-4827 | 2020-11-04 |
| 1760098727 | Anna Marie Jones | Counselor | 32 Portsmouth St, Jackson, OH 45640-1622 | 2020-09-16 |
| 1891313656 | Kayla Lynn Fazzari | Counselor | N168w20964 Main St, Jackson, WI 53037-9634 | 2020-07-08 |
| 1184184202 | Tracy Dawn Schuh | Counselor | 300 Morton St, Jackson, OH 45640-1028 | 2019-03-24 |
| 1013483858 | Bradley A Tompson | Counselor | 794 Mcdonough Rd Ste 100, Jackson, GA 30233-1572 | 2018-10-19 |
| 1295237048 | Impact Behavioral Counseling LLC | Counselor | 37 Sandstone Cir Ste 92b, Jackson, TN 38305-2089 | 2018-03-07 |
| 1942708920 | Candace R Downey | Counselor | 120 Twin Oaks Dr Unit D, Jackson, OH 45640-9506 | 2018-01-25 |
| 1508379462 | Vicki Lee Harper | Counselor | 295 Broadway St Ste 101, Jackson, OH 45640-1701 | 2017-11-14 |
| 1356867295 | Stephanie Michelle Gilbert | Counselor | 345 E Main St Ste A, Jackson, OH 45640-1780 | 2017-08-22 |
| 1477081206 | Trending Upwards | Counselor | 1754 Highway 15 N, Jackson, KY 41339 | 2017-05-24 |
| Find all providers in JACKSON | ||||
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| 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.