CORY R KRUEGER (NPI# 1417407297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417407297 |
| Entity Type | Individual |
| Full Name | CORY R KRUEGER |
| Credential | MS, LPC-IT, SAC-IT |
| Practice Address |
1541 Annex Rd Jefferson WI 53549-9803 |
| Mailing Address |
W7210 County Road V Lake Mills WI 53551-9645 |
| Practice Telephone | 9206743105 |
| Mailing Telephone | 9206485613 |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2016-10-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
17863-130 | WI | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
3039-226 | WI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700835006 | Cory Scott Krueger | Internal Medicine | 305 S Willard St, Cottonwood, AZ 86326-4127 | 2006-05-06 |
| Street Address |
1541 ANNEX RD |
| City | JEFFERSON |
| State | WI |
| Zip Code | 53549-9803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578562286 | Jefferson County | Clinic/Center | 1541 Annex Rd, Jefferson, WI 53549-9803 | 2005-07-15 |
| 1619584844 | Sean Arient | Social Worker | 1541 Annex Rd, Jefferson, WI 53549-9803 | 2020-10-01 |
| 1780290163 | Cassie A Hohlstein | Social Worker | 1541 Annex Rd, Jefferson, WI 53549-9803 | 2020-09-21 |
| 1770198988 | Gwendolyn J Olson | Social Worker | 1541 Annex Rd, Jefferson, WI 53549-9803 | 2020-09-14 |
| 1366057242 | Shelly Marie Theder | Social Worker | 1541 Annex Rd, Jefferson, WI 53549-9803 | 2020-09-09 |
| 1619580578 | Kassie Kluge | Social Worker | 1541 Annex Rd, Jefferson, WI 53549-9803 | 2020-08-28 |
| 1770101008 | Kenneth William Strege | Community Health Worker | 1541 Annex Rd, Jefferson, WI 53549-9803 | 2020-07-13 |
| 1023636313 | Bao Yang | Social Worker | 1541 Annex Rd, Jefferson, WI 53549-9803 | 2020-07-13 |
| 1124646757 | Laura Ann Bambrough | Social Worker | 1541 Annex Rd, Jefferson, WI 53549-9803 | 2020-07-09 |
| 1467070086 | Maureen Browning | Case Manager/Care Coordinator | 1541 Annex Rd, Jefferson, WI 53549-9803 | 2020-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740804913 | Anna E Warzala | Licensed Practical Nurse | Sunset Ridge Jefferson, 826 E. Reinel Street, Jefferson, Wi 53549, Jefferson, WI 53549 | 2020-06-03 |
| 1023428083 | Mary Beth Breunig | Occupational Therapist | 206 South Taft Avenue, Jefferson, WI 53549 | 2014-04-30 |
| 1841639952 | Debra Lee Schoenike | Licensed Practical Nurse | 610 S Main Street, Jefferson, WI 53549 | 2013-06-21 |
| 1073762191 | Katherine Sue Drechsler | Counselor | 1541 Annex Road, Jefferson, WI 53549 | 2008-09-12 |
| 1497960645 | Family Resources Associates Inc | Counselor | 248 S Wisconsin Drive, Jefferson, WI 53549 | 2007-05-11 |
| 1386707529 | Todd G Goldbeck | Physical Therapist | 1515 Highway 26 South, Jefferson, WI 53549 | 2006-12-19 |
| 1982780813 | Sport & Spine Clinic of Fort Atkinson Limited Partnership | Physical Therapist | 222 S Wisconsin Drive, Suite 3, Jefferson, WI 53549 | 2006-10-31 |
| 1033202528 | Marie Ann Maxwell-jones | Occupational Therapist | N3995 Annex Road, Jefferson, WI 53549 | 2006-10-02 |
| 1447216551 | Diane Mary Voelker | Registered Nurse | 224 Connelly D R, Jefferson, WI 53549 | 2006-04-26 |
| 1063477065 | Cynthia Lynn Miller | Registered Nurse | W4949 Streim Lane, Jefferson, WI 53549 | 2006-04-20 |
| Find all providers in zip 53549 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326522863 | Brandon Shurn | Counselor | 4014 Mountville Rd # J, Jefferson, MD 21755-7713 | 2018-09-20 |
| 1821598491 | Kathryn Marie Stingl | Counselor | 115 S Fischer Ave, Jefferson, WI 53549-2123 | 2018-02-20 |
| 1306113279 | Navjot A. Redpath | Counselor | 1500 River Oaks Road W., Suite 100-a, Jefferson, LA 70123 | 2011-11-21 |
| 1326322934 | Ashleigh Gros Castro | Counselor | 2606 Audubon Trce, Jefferson, LA 70121-1561 | 2011-09-30 |
| 1346564416 | Allen Sinclair Young | Counselor | 827 Jefferson Walk Cir, Jefferson, GA 30549-5582 | 2010-03-18 |
| 1649425224 | Diane Wait | Counselor | 514 Mcconnell St, Jefferson, NC 28640-9789 | 2008-11-24 |
| 1225163603 | Jenny Diane Gibbs | Counselor | 224 North Main Street, Jefferson, NC 28640 | 2007-02-23 |
| 1477613180 | Todd S Capielano | Counselor | 4728 Jefferson Hwy, Jefferson, LA 70121-3125 | 2006-12-11 |
| 1184679680 | Martin Lyle Plog | Counselor | 2610 Highway 129 N, Jefferson, GA 30549-2652 | 2006-05-23 |
| 1922064864 | David John Ohrt | Counselor | 1217 W Lincolnway St, Jefferson, IA 50129-1671 | 2006-04-20 |
| Find all providers in JEFFERSON | ||||
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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.