JENNIFER ANNE GOODLUCK (NPI# 1235632779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235632779 |
| Entity Type | Individual |
| Full Name | JENNIFER ANNE GOODLUCK |
| Credential | MRSSP |
| Practice Address |
3001 Warrior Ln Poplar Bluff MO 63901-8685 |
| Practice Telephone | 5736861200 |
| Mailing Telephone | 5736861200 |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2018-03-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
3001 WARRIOR LN |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-8685 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083638506 | Robin Denise Vickery | Counselor | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2006-07-27 |
| 1235738493 | Family Counseling Center, Inc. | Clinic/Center | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-10-20 |
| 1972117620 | Selina Ann Mcklintic | Registered Nurse | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-09-01 |
| 1477163764 | Paula Kay Dawes | Case Manager/Care Coordinator | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-08-03 |
| 1275141921 | Matthew Owens | Behavior Technician | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-07-20 |
| 1730797564 | Holly Rebecca Carter | Counselor | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-07-17 |
| 1174144547 | Angela Michelle Slaughter | Case Manager/Care Coordinator | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-04-27 |
| 1215558655 | Ashley Don Scheffler | Case Manager/Care Coordinator | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-04-27 |
| 1922628510 | Jennifer Lee Taylor | Behavior Technician | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-04-23 |
| 1639708233 | Zackary James Ladyman | Licensed Practical Nurse | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2020-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790349371 | Amber Marie Brown | Peer Specialist | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2019-04-29 |
| 1114411147 | Angela Dawn Rommel | Peer Specialist | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2018-06-22 |
| 1639662521 | Laurisa Ann Usery | Peer Specialist | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2018-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518564426 | Tuesday Florence | Peer Specialist | 1312 Highland Dr, Rolla, MO 65401-3609 | 2020-10-04 |
| 1053926006 | Poetry for Personal Power | Peer Specialist | 1730 E 63rd St, Suite 300, Kansas City, MO 64110 | 2020-09-15 |
| 1487266011 | Jason Wade Moore | Peer Specialist | 5 West Pearce Boulevard, Wentzville, MO 63385 | 2020-08-17 |
| 1922642438 | Christine Marie Forrest | Peer Specialist | 1106 Marlowe St, Fredericktown, MO 63645-8835 | 2019-10-29 |
| 1326699950 | Family Advocacy and Community Training | Peer Specialist | 800 Friedens Rd Ste 200, Saint Charles, MO 63303-4198 | 2019-09-25 |
| 1073077509 | Katherine Anne Walters | Peer Specialist | 504 E Broadway Ste A, Ashland, MO 65010-9538 | 2019-01-29 |
| 1265958441 | Jessica Luedde | Peer Specialist | 1430 Olive St Fl 6, Saint Louis, MO 63103-2303 | 2017-08-18 |
| 1740718303 | Haywood Hughes | Peer Specialist | 1004 Goetz Blvd Apt 4, Joplin, MO 64801-1470 | 2017-05-26 |
| 1366848855 | Rosanna Metcalf | Peer Specialist | 925 State Highway W, Kennett, MO 63857 | 2014-11-10 |
| 1306198411 | Alicia Sutton | Peer Specialist | 248 Chez Vant Ct, Hazelwood, MO 63042-3542 | 2012-10-12 |
| Find all providers with the same taxonomy | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
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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.