MR. JERAMIE SOUSA GORMAN (NPI# 1265786891) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265786891 |
| Entity Type | Individual |
| Full Name | MR. JERAMIE SOUSA GORMAN |
| Credential | PLPC |
| Practice Address |
104 Crescent Dr Lebanon MO 65536-3301 |
| Mailing Address |
413 Harmony Rd Seymour MO 65746-7223 |
| Practice Telephone | 4175885885 |
| Mailing Telephone | 4179352799 |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2012-11-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 2012037683 | MO | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
2012037683 | MO | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
2012037683 | MO | Behavioral Health & Social Service Providers |
| Street Address |
104 CRESCENT DR |
| City | LEBANON |
| State | MO |
| Zip Code | 65536-3301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912044132 | Suzette Richmond | Counselor | 104 Crescent Dr, Lebanon, MO 65536-3301 | 2007-01-30 |
| 1285163709 | Sherrita M Allen | Counselor | 104 Crescent Dr, Lebanon, MO 65536-3301 | 2017-06-08 |
| 1215292271 | Calming The Storm | Counselor | 104 Crescent Dr, Lebanon, MO 65536-3301 | 2012-07-05 |
| 1073821963 | Charlotte A Moore | Counselor | 104 Crescent Dr, Lebanon, MO 65536-3301 | 2010-09-14 |
| 1639409873 | Crescent Center Counseling | Counselor | 104 Crescent Dr, Lebanon, MO 65536-3301 | 2010-01-11 |
| 1184864712 | Shannon Lee Williams | Counselor | 104 Crescent Dr, Lebanon, MO 65536-3301 | 2009-02-22 |
| 1619151750 | Lori Ranfeld | Counselor | 104 Crescent Dr, Lebanon, MO 65536-3301 | 2007-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427537307 | Cathy Jane Greenlee | Nurse Practitioner | 510 Hwy 32, Lebanon, MO 65536 | 2018-08-10 |
| 1396232831 | Steven Michael Majdecki | Counselor | 860 Lynn St., Lebanon, MO 65536 | 2018-04-19 |
| 1447629399 | Danielle Craig | Speech-Language Pathologist | 1200 Clark Ave, Lebanon, MO 65536 | 2015-09-22 |
| 1982080255 | Dawn Barker | Family Medicine | 331 Hospital Dr Ste C, Lebanon, MO 65536 | 2015-08-10 |
| 1194163840 | Laura Patton | Speech-Language Pathologist | 22864 Perimeter Drive, Lebanon, MO 65536 | 2013-06-04 |
| 1750588273 | Elaine Britzman | Registered Nurse | 874 S Jefferson St, Lebanon, MO 65536 | 2007-06-28 |
| 1538363486 | Laclede Co. Assoc. for Retarded Citizens | Respite Care | 200 Lawson Ave., Lebanon, MO 65536 | 2007-06-13 |
| 1568665768 | Fern M Klein | Registered Nurse | 874 S Jefferson, Lebanon, MO 65536 | 2007-06-06 |
| 1639201080 | Laclede County Assoc. for Retarded Citizens | Day Training, Developmentally Disabled Services | 200 Lawson Avenue, Lebanon, MO 65536 | 2007-03-12 |
| 1316078868 | Michael Montgomery Od PC | Optometrist | 279 E Elm, Lebanon, MO 65536 | 2007-03-08 |
| Find all providers in zip 65536 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750914248 | Marisol Cruz | Counselor | 128 S 4th St, Lebanon, PA 17042-6110 | 2020-02-13 |
| 1689176810 | Rebecca Mikaliunas | Counselor | 43 Conover Ter, Lebanon, NJ 08833-2180 | 2018-03-04 |
| 1487168670 | Stacy Nichole Davis | Counselor | 78 Rogers St, Lebanon, VA 24266 | 2017-11-27 |
| 1780109538 | David Allen Kinzer | Counselor | 1922 Arlington Rd, Lebanon, TN 37087-4224 | 2017-08-13 |
| 1457880346 | Sherri Ann Freas | Counselor | 75 Norfolk Ln, Lebanon, PA 17042-7538 | 2017-06-05 |
| 1245774348 | Missouri Behavioral Health Counseling Associates | Counselor | 1722 Bittersweet Ln, Lebanon, MO 65536-4362 | 2016-12-07 |
| 1033651492 | Cindy Joann Davis | Counselor | 2050 Pioneer Dr, Lebanon, VA 24266-5376 | 2016-11-15 |
| 1356899801 | Meghann Willean | Counselor | 496 Us Highway 22 Ste C, Lebanon, NJ 08833-5082 | 2016-09-13 |
| 1720489586 | Derrick Edwards | Counselor | 963 Gwynn Ln, Lebanon, TN 37087-9448 | 2014-09-11 |
| 1598179103 | Erin Corrine Hannah | Counselor | 986 Belvedere Drive, Lebanon, OH 45036-2821 | 2014-06-12 |
| Find all providers in LEBANON | ||||
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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.