JOHN P RISLOVE (NPI# 1396727376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396727376 |
| Entity Type | Individual |
| Full Name | JOHN P RISLOVE |
| Credential | LICSW |
| Practice Address |
123 16th Ave S Onalaska WI 54650-3109 |
| Mailing Address |
1836 South Ave La Crosse WI 54601-5429 |
| Practice Telephone | 6087968646 |
| Mailing Telephone | 6087827300 |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103TC0700X |
Psychologist Specialization: Clinical |
3840123 | WI | Behavioral Health & Social Service Providers |
| X | 103TC0700X |
Psychologist Specialization: Clinical |
7561 | MN | Behavioral Health & Social Service Providers |
| X | 1041C0700X |
Social Worker Specialization: Clinical |
3840 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | U CARE | 118042 | 01 |
| MN | BCBS | 5H180RI | 01 |
| WI | 43707800 | 05 |
| Street Address |
123 16TH AVE S |
| City | ONALASKA |
| State | WI |
| Zip Code | 54650-3109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285637595 | Kathleen M Adams | Social Worker | 123 16th Ave S, Onalaska, WI 54650-3109 | 2005-05-31 |
| 1407252489 | Gretchen Clements | Counselor | 123 16th Ave S, Onalaska, WI 54650-3109 | 2014-11-18 |
| 1356743496 | Michael John Sersch | Counselor | 123 16th Ave S, Onalaska, WI 54650-3109 | 2014-09-19 |
| 1871837567 | Gundersen Lutheran Medical Center, Inc | Clinic/Center | 123 16th Ave S, Onalaska, WI 54650-3109 | 2012-11-19 |
| 1558514893 | Terri L Nelson | Occupational Therapist | 123 16th Ave S, Onalaska, WI 54650-3109 | 2008-10-30 |
| 1497807796 | Jerald F Tabbert | Counselor | 123 16th Ave S, Onalaska, WI 54650-3109 | 2007-01-17 |
| 1316987191 | Gundersen Clinic, Ltd. | Clinic/Center | 123 16th Ave S, Onalaska, WI 54650-3109 | 2006-06-08 |
| 1609877869 | James C Harrison | Social Worker | 123 16th Ave S, Onalaska, WI 54650-3109 | 2005-08-09 |
| 1427059088 | Carla R Dahl | Counselor | 123 16th Ave S, Onalaska, WI 54650-3109 | 2005-08-04 |
| 1184620684 | Pamela K Radosen | Social Worker | 123 16th Ave S, Onalaska, WI 54650-3109 | 2005-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568824027 | Kyle Quillin | Student in an Organized Health Care Education/Training Program | 236 Kevin Ct, Onalaska, WI 54650 | 2016-03-24 |
| 1831577881 | Katelyn Nicole Patten | Counselor | 575 Lester Ave, Onalaska, WI 54650 | 2015-05-11 |
| 1619369758 | Amelia Vruble | Registered Nurse | 1047 Terrace Drive, Onalaska, WI 54650 | 2015-02-26 |
| 1699186528 | C. Nathan Vannatta | Physical Therapist | 3111 Gunersen Dr, Onalaska, WI 54650 | 2014-05-13 |
| 1770867640 | Claire Sweet | Pharmacist | 9400 Hwy 16, Target T-0620, Onalaska, WI 54650 | 2011-10-10 |
| 1306140439 | Jared I Darveaux | Internal Medicine | 311 Gundersen Dr, Onalaska, WI 54650 | 2011-01-04 |
| 1326299488 | Demetrios Spyridon Theodoropoulos | Allergy & Immunology | 2727 Midwest Drive, Onalaska, WI 54650 | 2008-10-08 |
| 1114190618 | Nancy Ellen Reithel | Physical Therapist | 610 Westwood Drive, Onalaska, WI 54650 | 2008-04-07 |
| 1902972896 | Maplewood Dental | Dentist | 1202 County Trunk Ph, Suite 300, Onalaska, WI 54650 | 2006-11-24 |
| 1245309327 | Benjamin John Breidenbach | Chiropractor | 1640 George St, Lacrosse, WI 54650 | 2006-11-06 |
| Find all providers in zip 54650 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922289404 | Christopher Charles Newton | Psychologist | 571 Braund St, Onalaska, WI 54650-8556 | 2007-11-26 |
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|---|---|---|---|---|
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| 1972124980 | Lake Geneva Psychology, Inc. | Psychologist | 630 Kenosha St, Walworth, WI 53184-9505 | 2020-04-30 |
| 1487283669 | Maria Gambaro | Psychologist | W4557 Gillette Dr, Montello, WI 53949-8951 | 2020-04-08 |
| 1386283810 | Troy William Sheide | Psychologist | 498 Ruggles St, Fond Du Lac, WI 54935-3931 | 2020-01-01 |
| 1871138115 | Point Counseling Center LLC | Psychologist | 1547 Strongs Ave Ste D, Stevens Point, WI 54481-3566 | 2019-11-11 |
| 1508417916 | Cassandra D Pasquariello | Psychologist | Department of Athletics, 1440 Monroe Street, Madison, WI 53711 | 2019-09-26 |
| 1023673563 | Robert E Young | Psychologist | 735 N Water St Ste 712, Milwaukee, WI 53202-4104 | 2019-05-09 |
| 1346705951 | Joseph John Abhold | Psychologist | 402 Graham Ave Ste 208, Eau Claire, WI 54701-2633 | 2019-02-07 |
| 1972075661 | Moonlight Psychotherapy and Psychological Services, LLC | Psychologist | 205 5th Ave S Ste 428, La Crosse, WI 54601-4059 | 2018-12-19 |
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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.