PATRICE L JERNEGONS (NPI# 1114526274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114526274 |
| Entity Type | Individual |
| Full Name | PATRICE L JERNEGONS |
| Credential | LCDC |
| Practice Address |
107 Woodbine Pl Longview TX 75601-2912 |
| Practice Telephone | 9037582471 |
| Practice Fax Number | 9032341639 |
| Mailing Telephone | 9037582471 |
| Mailing Fax Number | 9032341639 |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-10-20 |
| 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) |
9010 | TX | Behavioral Health & Social Service Providers |
| Street Address |
107 WOODBINE PL |
| City | LONGVIEW |
| State | TX |
| Zip Code | 75601-2912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467561209 | Renee Lynn Todd | Social Worker | 107 Woodbine Pl, Longview, TX 75601-2912 | 2006-08-29 |
| 1942809678 | Sandra Davis | Counselor | 107 Woodbine Pl, Longview, TX 75601-2912 | 2020-10-23 |
| 1891394854 | Brenda Cleary | Counselor | 107 Woodbine Pl, Longview, TX 75601-2912 | 2020-10-21 |
| 1770182842 | Pamela Kelley | Counselor | 107 Woodbine Pl, Longview, TX 75601-2912 | 2020-10-20 |
| 1235775917 | Kathryn Marie Stolle | Counselor | 107 Woodbine Pl, Longview, TX 75601-2912 | 2019-11-18 |
| 1841835022 | Sabine Valley Regional Mhmr Center | Family Medicine | 107 Woodbine Pl, Longview, TX 75601-2912 | 2019-11-12 |
| 1396303046 | Arturo Morales | Counselor | 107 Woodbine Pl, Longview, TX 75601-2912 | 2019-05-29 |
| 1023554888 | Tammy Watson-smith | Speech-Language Pathologist | 107 Woodbine Pl, Longview, TX 75601-2912 | 2017-01-17 |
| 1407230733 | Angela Thompson | Speech-Language Pathologist | 107 Woodbine Pl, 775, Longview, TX 75601-2912 | 2015-07-16 |
| 1396131470 | Patricia George | Specialist | 107 Woodbine Pl, #775, Longview, TX 75601-2912 | 2015-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992351076 | Stebbins Hospice LLC | Hospice Care, Community Based | 600-602 E. Whaley, Longview, TX 75601 | 2019-08-14 |
| 1720437692 | J.l. Miguez, Inc. | Hearing Aid Equipment | 822 N 4th Street, Longview, TX 75601 | 2016-06-10 |
| 1801244090 | Voyage Medical Solutions, LLC | Durable Medical Equipment & Medical Supplies | 111 W Tyler St, Longview, TX 75601 | 2016-05-27 |
| 1134504426 | Siobain Kay Rogers | Nurse Practitioner | 703 E Marshall Ave Ste 4003, Longview, TX 75601 | 2015-07-28 |
| 1669882882 | Snehal Shrivastava | Internal Medicine | 1402 N 4th St Ste 300, Longview, TX 75601 | 2014-04-28 |
| 1679824221 | Jennifer Ruth Williams | Occupational Therapist | 110 E Tyler St, Longview, TX 75601 | 2012-09-23 |
| 1548525603 | Candice Renee Ramos | Social Worker | 950 N Sixth St, Longview, TX 75601 | 2012-07-05 |
| 1497082747 | Jarett S Harkness | Pharmacist | 511 E. Marshall Avenue, Longview, TX 75601 | 2009-11-06 |
| 1407086333 | Udeme Ekpenyong | Pediatrics | 818 N. 4th St., Longview, TX 75601 | 2009-07-27 |
| 1386823359 | Assisted Living Concepts Inc | Assisted Living Facility | 2104 Alpine Road, Longview, TX 75601 | 2007-10-26 |
| Find all providers in zip 75601 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144862913 | Kendra Piper | Counselor | 640 Olson Rd, Longview, WA 98632-5674 | 2019-10-14 |
| 1639635444 | G and T Young At Heart | Counselor | 1012 E Cotton St, Longview, TX 75602-1322 | 2019-02-17 |
| 1194293118 | Elaine Neagle | Counselor | 110 E Hawkins Pkwy Apt 2603, Longview, TX 75605-3694 | 2018-11-07 |
| 1932698008 | John Robert Potter | Counselor | 551 21st Ave, Longview, WA 98632-1303 | 2018-05-04 |
| 1265943658 | Lauri Anne Rowland | Counselor | 1839 1st Ave, Longview, WA 98632-3267 | 2017-10-12 |
| 1356709729 | Melissa A Huston | Counselor | 2401 Judson Rd Ste 104, Longview, TX 75605-4636 | 2016-02-01 |
| 1871859280 | Peter Thaddeaus Weiss | Counselor | 1301 Bent Tree Ln, Longview, TX 75605-9765 | 2012-04-10 |
| 1669743142 | Jane D Morris | Counselor | 522 N 1st St Apt 213, Longview, TX 75601-6435 | 2012-01-16 |
| 1891957205 | Krista R Heppe | Counselor | 1055 9th Ave Ste D, Longview, WA 98632-2661 | 2008-06-26 |
| 1811919392 | Sally Gossett Barron | Counselor | 107 Community Blvd Ste 1, Longview, TX 75605-6186 | 2006-07-24 |
| Find all providers in LONGVIEW | ||||
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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.