LISA INGRUM (NPI# 1457472375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457472375 |
| Entity Type | Individual |
| Full Name | LISA INGRUM |
| Practice Address |
1530 Lincoln Ave Charleston IL 61920-3057 |
| Practice Telephone | 2173480127 |
| Practice Fax Number | 2173480740 |
| Mailing Telephone | 2173480127 |
| Mailing Fax Number | 2173480740 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1530 LINCOLN AVE |
| City | CHARLESTON |
| State | IL |
| Zip Code | 61920-3057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588701429 | Ccar Industries | Day Training, Developmentally Disabled Services | 1530 Lincoln Ave, Charleston, IL 61920-3057 | 2007-01-31 |
| 1740832237 | Mary Gienko | Developmental Therapist | 1530 Lincoln Ave, Charleston, IL 61920-3057 | 2019-07-15 |
| 1184147563 | Denise R Glick | Developmental Therapist | 1530 Lincoln Ave, Charleston, IL 61920-3057 | 2017-07-18 |
| 1861800484 | Jennifer Carter-alvis | Developmental Therapist | 1530 Lincoln Ave, Charleston, IL 61920-3057 | 2014-07-28 |
| 1821429168 | Mindy Lynn Beurskens | Developmental Therapist | 1530 Lincoln Ave, Charleston, IL 61920-3057 | 2013-12-12 |
| 1033555990 | Nicole Kuhns | Counselor | 1530 Lincoln Ave, Charleston, IL 61920-3057 | 2013-05-20 |
| 1144527367 | Alice Jean Shonk | Behavioral Analyst | 1530 Lincoln Ave, Charleston, IL 61920-3057 | 2011-02-24 |
| 1649391525 | Ellie White | Developmental Therapist | 1530 Lincoln Ave, Charleston, IL 61920-3057 | 2007-04-02 |
| 1437270345 | Shirley Anne White | Developmental Therapist | 1530 Lincoln Ave, Charleston, IL 61920-3057 | 2007-04-02 |
| 1871614743 | Linda Mcphee | Developmental Therapist | 1530 Lincoln Ave, Charleston, IL 61920-3057 | 2007-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124643879 | Jenna Kay Mortensen | Speech-Language Pathologist | 2086 7th Street, Charleston, IL 61920 | 2020-06-09 |
| 1255954566 | Christina L. White | Nurse Practitioner | 1199 Persimmon Rd, Charleston, IL 61920 | 2020-05-20 |
| 1679066773 | Jennifer Hess | Specialist/Technologist | 2506 Lantz Building, Charleston, IL 61920 | 2018-06-13 |
| 1134647969 | Nichole C Ogilvie | Student in an Organized Health Care Education/Training Program | 917 4th Street Apt 19, Charleston, IL 61920 | 2017-08-31 |
| 1467970319 | Marcus Roach | Physical Therapy Assistant | 912 Oakcrest Dr. Apt D, Charleston, IL 61920 | 2017-08-30 |
| 1114478500 | 5 Guys Rx II LLC | Pharmacy | 1 W Lincoln Ave, Charleston, IL 61920 | 2016-10-20 |
| 1649723206 | Bright Minds Educational Program Inc | Developmental Therapist | 7704 Deerpath Road, Charleston, IL 61920 | 2016-08-01 |
| 1760843379 | Lisa Price | Nurse Practitioner | 2040 Lincoln Ave, Suite 100, Charleston, IL 61920 | 2016-03-09 |
| 1104243385 | Nathan David Schwartzkopf | Specialist/Technologist | 1340 A Street, Charleston, IL 61920 | 2014-03-25 |
| 1558694349 | Emily Schilling | Specialist/Technologist | 2350 Harrison Avenue, Charelston, IL 61920 | 2009-09-10 |
| Find all providers in zip 61920 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649723206 | Bright Minds Educational Program Inc | Developmental Therapist | 7704 Deerpath Road, Charleston, IL 61920 | 2016-08-01 |
| 1174984645 | Ashia George | Developmental Therapist | 6650 Rivers Avenue, Ste 100, Charleston, SC 29406 | 2016-03-11 |
| 1942628185 | Sarah Katherine Henderson | Developmental Therapist | 125 E St Apt 1, Charleston, IL 61920-1387 | 2014-04-04 |
| 1538484928 | Brittany Nicole Phebus | Developmental Therapist | 18825 State Highway 16, Charleston, IL 61920-8316 | 2010-03-29 |
| 1952509697 | Lisa A Mcdaniel | Developmental Therapist | 628 14th St, Charleston, IL 61920-2203 | 2007-07-03 |
| 1578778403 | Central Illinois Developmental Therapy, Inc. | Developmental Therapist | 762 8th St, Charleston, IL 61920-2116 | 2007-05-14 |
| 1710192653 | Vivian Faye Skelley | Developmental Therapist | 7704 Deerpath Rd, Charleston, IL 61920-8735 | 2007-05-14 |
| 1740832237 | Mary Gienko | Developmental Therapist | 1530 Lincoln Ave, Charleston, IL 61920-3057 | 2019-07-15 |
| 1184147563 | Denise R Glick | Developmental Therapist | 1530 Lincoln Ave, Charleston, IL 61920-3057 | 2017-07-18 |
| 1487010856 | Pamela Ervin | Developmental Therapist | 1600 Lincoln Ave, Charleston, IL 61920-2982 | 2016-01-14 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 61920 |
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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.