MRS. STACEY MICHELLE VANDERKOLK


Address: 54 S Jackson St, Janesville, WI 53548-3837
Phone: 6087528716

MRS. STACEY MICHELLE VANDERKOLK (NPI# 1326291170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1326291170
Entity Type Individual
Full Name MRS. STACEY MICHELLE VANDERKOLK
Other Name MISS STACEY MICHELLE BENNETT
Credential BA CADC
Practice Address 54 S Jackson St
Janesville
WI 53548-3837
Mailing Address 1601 University Drive
Rockford
IL 61107
Practice Telephone 6087528716
Mailing Telephone 8153911000
Mailing Fax Number 8153915040
Enumeration Date 2008-10-24
Last Update Date 2009-07-22
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
22263 IL Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
IL 42254500 05

Office Location

Street Address 54 S JACKSON ST
City JANESVILLE
State WI
Zip Code 53548-3837

Providers in the same location

NPI Name Taxonomy Address Enumeration
1245480060 Rosecrance, Inc. Substance Abuse Rehabilitation Facility 54 S Jackson St, Janesville, WI 53548-3837 2008-09-29
1013535012 Hannah E Leclair Social Worker 54 S Jackson St, Janesville, WI 53548-3837 2020-07-07
1215554597 Rhiannon Marie Decker Social Worker 54 S Jackson St, Janesville, WI 53548-3837 2020-07-02
1417574971 Elizabeth White Social Worker 54 S Jackson St, Janesville, WI 53548-3837 2020-07-01
1083231559 Isabelle Zahn Social Worker 54 S Jackson St, Janesville, WI 53548-3837 2020-07-01

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1578846010 Patricia Ann Sheets Licensed Vocational Nurse 316 N. Terrace St., Janbesville, WI 53548 2011-09-21
1760658983 Kristy Kay Prentice Kerl Dental Hygienist 121 Jonathon Dr, Janesville, WI 53548 2008-05-07
1316005978 City of Janesville Emergency Medical Technician, Paramedic 18 N Jackson St, Janesville, WI 53548 2006-12-05
1558464115 Sarah Louise Hessenauer Social Worker 17 S. River St, Suite 254, Janesville, WI 53548 2006-09-07
1073548327 Mary Katherine Cefalu Registered Nurse 17 S. River, Suite 254, Janesville, WI 53548 2006-07-12
1699707950 Gary Lavern Jones Counselor 175 River, Suite 254, Janesville, WI 53548 2006-07-07
1295767424 Michael Stuart Kaye Clinical Neuropsychologist 17 S River St Ste 254, Janesville, WI 53548 2006-07-07
1205864055 Amy Laurie Roy Counselor 17 S River Suite 254, Janesville, WI 53548 2006-06-29
1518903566 Leota I Larson Psychologist 17 S River, Suite 254, Janesville, WI 53548 2006-06-20
1760950414 North Star Chiropractic LLC Chiropractor 21 S Jackson St, Ste 160, Janesville, WI 53548 2018-11-10
Find all providers in zip 53548

Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1700131232 Tiffany L Strodthoff Counselor 15 W Milwaukee St Ste 207, Janesville, WI 53548-2998 2012-07-20
1396018131 Holli K Tinder Counselor 2000 E Racine St Ste 120, Janesville, WI 53545-4300 2012-02-09
1821398736 Passageway, Inc. Frs-tr Counselor 3246 W Rollingwood Dr, Janesville, WI 53545-9030 2010-10-25
1154631679 Cheryl M Frei Counselor 200 S Parker Dr, Janesville, WI 53545-3932 2010-10-18
1851546667 Amanda L Ballard Counselor 2600 Humes Rd Ste 100, Janesville, WI 53545 2008-11-20
1376711671 Kim N Conrad Counselor 612 N Randall Ave Ste A, Janesville, WI 53545-1958 2008-02-20
1093992158 Emma Gene Harrell Counselor 203 W Sunny Lane, Janesville, WI 53546 2008-01-30
1265562037 Kathleen M Miller Counselor 3246 W. Rollingwood Drive, Janesville, WI 53545-9030 2007-03-07
1710076914 William Hollingsworth Counselor 2640 Milton Ave, Janesville, WI 53545-0231 2006-10-12
1255348314 Sam Paul Romano Jr. Counselor 612 N Randall Ave, Janesville, WI 53545-1958 2006-08-02
Find all providers in JANESVILLE

Competitor

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City JANESVILLE
Zip Code 53548

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Dataset Information

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.

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