MICHAEL KOLESSAR (NPI# 1134458201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134458201 |
Entity Type | Individual |
Full Name | MICHAEL KOLESSAR |
Credential | PSY.D. |
Practice Address |
12380 De Paul Dr Bridgeton MO 63044-2511 |
Practice Telephone | 3144479705 |
Mailing Telephone | 3144479705 |
Enumeration Date | 2009-12-18 |
Last Update Date | 2013-10-03 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
Street Address |
12380 DE PAUL DR |
City | BRIDGETON |
State | MO |
Zip Code | 63044-2511 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316979065 | Carol Yvonne Crooks | Physical Medicine & Rehabilitation | 12380 De Paul Dr, Ssm Rehab Hospital, Bridgeton, MO 63044-2511 | 2006-07-06 |
1871107318 | Richard A Smith | Speech-Language Pathologist | 12380 De Paul Dr, Bridgeton, MO 63044-2511 | 2020-09-02 |
1720690159 | Celsey Louise Royer | Occupational Therapist | 12380 De Paul Dr, Bridgeton, MO 63044-2511 | 2020-08-18 |
1225647027 | Jordan Elizabeth Prutzer | Physical Therapist | 12380 De Paul Dr, Bridgeton, MO 63044-2511 | 2020-07-28 |
1033727524 | Katherine Bishop Bennington | Physical Therapist | 12380 De Paul Dr, Bridgeton, MO 63044-2511 | 2020-07-21 |
1598382111 | Chelsea Ann Dill | Speech-Language Pathologist | 12380 De Paul Dr, Bridgeton, MO 63044-2511 | 2020-06-30 |
1790302289 | Jadean Hoff | Physical Therapist | 12380 De Paul Dr, Bridgeton, MO 63044-2511 | 2020-06-30 |
1346864626 | Casie Ludwig | Occupational Therapist | 12380 De Paul Dr, Bridgeton, MO 63044-2511 | 2020-06-03 |
1417570219 | Emily Claire Leonard | Occupational Therapist | 12380 De Paul Dr, Bridgeton, MO 63044-2511 | 2020-05-27 |
1750900585 | Rachel Elizabeth O'bannon | Speech-Language Pathologist | 12380 De Paul Dr, Bridgeton, MO 63044-2511 | 2020-04-12 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
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Taxonomy Code | 103G00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Clinical Neuropsychologist |
An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043322076 | Patricia V. Cooper | Clinical Neuropsychologist | 12380 Depaul Dr., Ssm Rehabilitation Hospital - Physician's Services, Bridgeton, MO 63044-2588 | 2006-08-31 |
1831541200 | Kristin Hannah Hinrichs | Clinical Neuropsychologist | 12380 Depaul Drive, Bridgeton, MO 63044 | 2016-07-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144873159 | Stephanie Ross Potts | Clinical Neuropsychologist | 1027 Bellevue Ave Ste 142, Saint Louis, MO 63117-1851 | 2019-07-18 |
1780127449 | Gateway Neuropsychology, LLC | Clinical Neuropsychologist | 989 Gardenview Office Pkwy, Creve Coeur, MO 63141-5917 | 2016-11-29 |
1508259003 | Maria Catherine Rothhaar | Clinical Neuropsychologist | 522 N New Ballas Rd Ste 121, Saint Louis, MO 63141-6820 | 2015-03-09 |
1578909925 | Sharon Brooks | Clinical Neuropsychologist | 2209 Potomac Dr, Columbia, MO 65203-5886 | 2013-05-13 |
1306190913 | Robert L Coffman | Clinical Neuropsychologist | 1245 N Butterfield Rd Ste C1, Bolivar, MO 65613-3017 | 2012-11-05 |
1366790941 | Pediatric Neuropsychological Services, LLC | Clinical Neuropsychologist | 175 S. Marshall, Suite G, Rogersville, MO 65742 | 2012-08-29 |
1750612925 | Stress Control Center Inc, P C | Clinical Neuropsychologist | 800 W 47th St Ste 514, Kansas City, MO 64112-1247 | 2010-01-27 |
1366694937 | Dawn Heather Huber | Clinical Neuropsychologist | 175 S Marshall St, Suite G, Rogersville, MO 65742-8828 | 2008-10-15 |
1689852253 | Stacey Woodrome | Clinical Neuropsychologist | 3800 Park Ave Fl 2, Saint Louis, MO 63110-2514 | 2008-02-06 |
1659551406 | Wright & Wright, Phd, LLC | Clinical Neuropsychologist | 16141 Swingley Ridge Rd, Suite 106, Chesterfield, MO 63017-1774 | 2007-11-09 |
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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.