PHILLIP STULTZ (NPI# 1104316736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104316736 |
| Entity Type | Individual |
| Full Name | PHILLIP STULTZ |
| Practice Address |
14572 Us Highway 23 Ste A Waverly OH 45690-9448 |
| Mailing Address |
Po Box 226 Waverly OH 45690-0226 |
| Practice Telephone | 7409476727 |
| Mailing Telephone | 7409476727 |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2018-05-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
14572 US HIGHWAY 23 STE A |
| City | WAVERLY |
| State | OH |
| Zip Code | 45690-9448 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629589106 | Roy A Lowery | Counselor | 14572 Us Highway 23 Ste A, Waverly, OH 45690-9448 | 2017-10-24 |
| 1801371976 | Jennifer Sue Montgomery | Counselor | 14572 Us Highway 23 Ste A, Waverly, OH 45690-9448 | 2018-09-25 |
| 1528550233 | Krista Jones | Counselor | 14572 Us Highway 23 Ste A, Waverly, OH 45690-9448 | 2018-05-30 |
| 1427548635 | Branden Elkins | Counselor | 14572 Us Highway 23 Ste A, Waverly, OH 45690-9448 | 2018-05-14 |
| 1700375573 | Donald Entler | Counselor | 14572 Us Highway 23 Ste A, Waverly, OH 45690-9448 | 2018-05-07 |
| 1265921316 | Roger Moore | Counselor | 14572 Us Highway 23 Ste A, Waverly, OH 45690-9448 | 2018-05-04 |
| 1295235679 | Jerri Dawn Moore | Counselor | 14572 Us Highway 23 Ste A, Waverly, OH 45690-9448 | 2018-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538767181 | Brandie Mustard | Homemaker | 3018 My Tabor Rd, Waverly, OH 45690 | 2020-10-15 |
| 1225661168 | Kyle Colley | Counselor | 14574 Us Hughway 23, Waverly, OH 45690 | 2020-02-19 |
| 1366082513 | Ryan Rawlins | Counselor | 14574 St. Rt. 23, Waverly, OH 45690 | 2020-01-15 |
| 1700424140 | Jaime Wooldridge | Counselor | 14532 St. Rt. 23, Waverly, OH 45690 | 2019-12-17 |
| 1518513415 | Jacquelyn Irene Sprouse | Counselor | 217 Emmitt Ave, Waverly, OH 45690 | 2019-08-15 |
| 1639634850 | Krista K Leeth | Counselor | 14532 Us Hwy 23, 14534 Us Hwy 23, Waverly, OH 45690 | 2019-02-01 |
| 1881196244 | Kevin Michael Reichert | Counselor | Pike County Recovery Council, 218 East North Street, Waverly, OH 45690 | 2018-03-01 |
| 1619483179 | Ticia Lewis | Counselor | 14532 State Route 23, Waverly, OH 45690 | 2017-12-20 |
| 1205342136 | Criston B Evans | Licensed Practical Nurse | 14532 Us Highway 23, Waverly, OH 45690 | 2017-12-14 |
| 1447763313 | Jody Ryan Colley | Counselor | 14572 St. Rt. 23, Waverly, OH 45690 | 2017-11-14 |
| Find all providers in zip 45690 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225661168 | Kyle Colley | Counselor | 14574 Us Hughway 23, Waverly, OH 45690 | 2020-02-19 |
| 1366082513 | Ryan Rawlins | Counselor | 14574 St. Rt. 23, Waverly, OH 45690 | 2020-01-15 |
| 1700424140 | Jaime Wooldridge | Counselor | 14532 St. Rt. 23, Waverly, OH 45690 | 2019-12-17 |
| 1518513415 | Jacquelyn Irene Sprouse | Counselor | 217 Emmitt Ave, Waverly, OH 45690 | 2019-08-15 |
| 1639634850 | Krista K Leeth | Counselor | 14532 Us Hwy 23, 14534 Us Hwy 23, Waverly, OH 45690 | 2019-02-01 |
| 1922572353 | Kristin Patricia Wilson | Counselor | 196c E Emmitt Ave, Waverly, OH 45690-1334 | 2019-01-18 |
| 1821587718 | Cathy Cummings | Counselor | 14416 Us Highway 23, Waverly, OH 45690-9337 | 2018-05-07 |
| 1821587973 | Jonathan Leatherwood | Counselor | 14572 Us Highway 23 Ste E, Waverly, OH 45690-9448 | 2018-05-04 |
| 1881196244 | Kevin Michael Reichert | Counselor | Pike County Recovery Council, 218 East North Street, Waverly, OH 45690 | 2018-03-01 |
| 1164922548 | Brenda Jones | Counselor | 14572 Us Highway 23 Ste F, Waverly, OH 45690-9454 | 2018-02-13 |
| Find all providers in WAVERLY | ||||
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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.