MRS. KELLY TERVOL (NPI# 1366860470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366860470 |
| Entity Type | Individual |
| Full Name | MRS. KELLY TERVOL |
| Practice Address |
6692 Spring Arbor Rd Jackson MI 49201-9322 |
| Practice Telephone | 5177503869 |
| Mailing Telephone | 5177503869 |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2014-04-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
6401013548 | MI | Behavioral Health & Social Service Providers |
| Street Address |
6692 SPRING ARBOR RD |
| City | JACKSON |
| State | MI |
| Zip Code | 49201-9322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558475012 | Brent Roderick Smith | Psychologist | 6692 Spring Arbor Rd, Jackson, MI 49201 | 2006-08-19 |
| 1003372368 | Chelsea Kae Wells | Psychologist | 6692 Spring Arbor Rd, Jackson, MI 49201-9322 | 2019-02-12 |
| 1427540913 | Randall Eric Cole | Counselor | 6692 Spring Arbor Rd, Jackson, MI 49201-9322 | 2018-05-31 |
| 1407392731 | Matthew Smith | Psychologist | 6692 Spring Arbor Rd, Jackson, MI 49201-9322 | 2017-01-10 |
| 1093187338 | Elisabeth Smith | Psychologist | 6692 Spring Arbor Rd, Jackson, MI 49201-9322 | 2015-10-27 |
| 1336576073 | Lissa Lynn Cole | Counselor | 6692 Spring Arbor Rd, Jackson, MI 49201-9322 | 2013-09-26 |
| 1942549779 | Bethany Kaye Saunders | Counselor | 6692 Spring Arbor Rd, Jackson, MI 49201-9322 | 2013-02-14 |
| 1538423678 | Jamie Lea Lee | Counselor | 6692 Spring Arbor Rd, Jackson, MI 49201-9322 | 2012-07-03 |
| 1295051514 | Joell Lavonne Sanchez-deleon | Psychologist | 6692 Spring Arbor Rd, Jackson, MI 49201-9322 | 2010-04-12 |
| 1336475177 | Rachel Flowers | Social Worker | 6692 Spring Arbor Rd, Jackson, MI 49201-9322 | 2009-10-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174137863 | Sally Ann Shaw | Behavior Technician | 3699 Miles Rd., Jackson, MI 49201 | 2020-09-01 |
| 1780293043 | Alyn Kristin Kay | Technician | Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 | 2020-07-23 |
| 1841827946 | Maverick Jubane | Student in an Organized Health Care Education/Training Program | Henry Ford Allegiance Health, 205 N East Avenue, Jackson, MI 49201 | 2020-03-26 |
| 1306486584 | Cody Williams | Technician, Other | 1001 Laurence Avenue St E, Jackson, MI 49201 | 2020-01-15 |
| 1720632292 | Krystie Lynn Adorjan | Speech-Language Pathologist | 1175 W Parnall Rd, Jackson, MI 49201 | 2019-08-01 |
| 1407412653 | Howard Franklin Tanner II | Speech-Language Pathologist | 102 East Michigan Avenue, Jackson, MI 49201 | 2019-05-14 |
| 1356863740 | Rima Zarar Qayyum | Speech-Language Pathologist | 4800 Firethorn Dr., Jackson, MI 49201 | 2017-07-07 |
| 1306384383 | Briana Nesmith | Speech-Language Pathologist | 2025 Ann Arbor Road, Jackson, MI 49201 | 2017-02-09 |
| 1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
| 1306212881 | Aisha Henderson | Social Worker | 729 West Michigan Avenue, Jackson, MI 49201 | 2015-08-19 |
| Find all providers in zip 49201 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677893 | Jackson Healing Clinic LLC | Counselor | 2020 Cascade Dr, Jackson, MI 49203-3810 | 2020-10-20 |
| 1568069524 | Philip Ray Nicholas | Counselor | 19 Wood Duck Cv, Jackson, TN 38305-6632 | 2020-10-02 |
| 1184242711 | New Life Goals, LLC | Counselor | 504 Cooper Rd, Jackson, MS 39212-4704 | 2020-07-09 |
| 1548881048 | Gloria Dansby-giles | Counselor | 4500 Interstate 55, North; Suite 220, Jackson, MS 39211 | 2020-05-06 |
| 1962023812 | Kandace Ross | Counselor | 528 Woodbury Rd, Jackson, MS 39206-4830 | 2020-05-01 |
| 1629600945 | Modern Hope of Ms,llc | Counselor | 5825 Kings Pl, Jackson, MS 39211-3321 | 2020-02-05 |
| 1003447657 | Chandler & Associates, LLC | Counselor | 1900 Dunbarton Dr Ste G, Jackson, MS 39216-5015 | 2020-02-03 |
| 1659910701 | Laura E Rutledge | Counselor | 1437 Old Square Rd Ste 101, Jackson, MS 39211-5533 | 2020-01-06 |
| 1154960961 | Timothy A Norris | Counselor | 5026 Raintree Dr, Jackson, MS 39272-5753 | 2019-12-26 |
| 1982243838 | Paula Jane Blocker | Counselor | 401 West St Ste 117, Jackson, MN 56143-1219 | 2019-12-24 |
| Find all providers in JACKSON | ||||
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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.