REGINALD SISTRUNK II (NPI# 1457992406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457992406 |
| Entity Type | Individual |
| Full Name | REGINALD SISTRUNK II |
| Practice Address |
4124 Linden Ave Dayton OH 45432-3018 |
| Practice Telephone | 9375220961 |
| Mailing Telephone | 9375220961 |
| Enumeration Date | 2019-10-01 |
| Last Update Date | 2019-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
4124 LINDEN AVE |
| City | DAYTON |
| State | OH |
| Zip Code | 45432-3018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417206954 | Cornerstone Project, LLC | Psychologist | 4124 Linden Ave, Suite 100, Dayton, OH 45432-3018 | 2012-08-30 |
| 1841803236 | Derek Beasley | Counselor | 4124 Linden Ave, Dayton, OH 45432-3018 | 2020-08-26 |
| 1487278958 | Davina U Williams | Counselor | 4124 Linden Ave, Dayton, OH 45432-3018 | 2020-06-01 |
| 1497375661 | Johntae Smoot | Counselor | 4124 Linden Ave, Dayton, OH 45432-3018 | 2020-04-17 |
| 1154940211 | Jessica Ford | Counselor | 4124 Linden Ave, Dayton, OH 45432-3018 | 2020-04-09 |
| 1558998427 | Brittany Noel Wilson | Counselor | 4124 Linden Ave, Dayton, OH 45432-3018 | 2020-03-23 |
| 1043851090 | Michael Ward | Counselor | 4124 Linden Ave, Dayton, OH 45432-3018 | 2019-10-01 |
| 1710528765 | Nathan Miller Jr. | Counselor | 4124 Linden Ave, Dayton, OH 45432-3018 | 2019-10-01 |
| 1427607068 | Jacki Peterson | Counselor | 4124 Linden Ave, Dayton, OH 45432-3018 | 2019-09-06 |
| 1891343885 | Gillyan Baccus | Counselor | 4124 Linden Ave, Dayton, OH 45432-3018 | 2019-09-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538789284 | Shannon Davis Kaufman | Counselor | National Youth Advocate Program, 1020 Woodman Drive Suite 330, Dayton, OH 45432 | 2020-04-23 |
| 1215480504 | Heather Iaquinta | Registered Nurse | 1430 Linden Ave., Suite 390, Dayton, OH 45432 | 2016-08-03 |
| 1346586682 | Jeffrey Craig Miller | Dentist | 4450 Linden Ave., Dayton, OH 45432 | 2012-12-13 |
| 1194997718 | Paul G Tarlano Dds Inc | Dentist | 3621 Dayton-xenia Rd, Beaver Creek, OH 45432 | 2008-03-25 |
| 1306018981 | Paul Gerald Tarlano | Dentist | 3621 Dayton Xenia Rd, Beavercreek, OH 45432 | 2008-03-24 |
| 1104035377 | Andrew Brody | Occupational Therapy Assistant | 1974 North Fairfield Road, Beavercreek, OH 45432 | 2007-05-22 |
| 1952476111 | Jeffrey C Miller Dds Inc | Dentist | 4450 Linden Ave, Dayton, OH 45432 | 2006-11-22 |
| 1194898098 | Joseph Warren Shiveley | Dentist | 1555 Marsetta Drive, Dayton, OH 45432 | 2006-11-16 |
| 1710907597 | Integrated Youth Services Inc | Clinic/Center | 1321 Research Park Drive, Dayton, OH 45432 | 2006-07-21 |
| 1730106790 | Lorena L Kvalheim | Psychologist | 1020 Woodman Street, Suite 300, Dayton, OH 45432 | 2006-07-16 |
| Find all providers in zip 45432 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271546 | Laura Frericks | Counselor | 4577 Frederick Pike Apt D, Dayton, OH 45414-3940 | 2020-10-05 |
| 1578170056 | Taylor Katherine Bevins | Counselor | 856 Hyde Park Dr, Dayton, OH 45429-5840 | 2020-09-28 |
| 1528689676 | Yvonne Marie Randel | Counselor | 519 County Road 4011, Dayton, TX 77535-7386 | 2020-04-29 |
| 1538789284 | Shannon Davis Kaufman | Counselor | National Youth Advocate Program, 1020 Woodman Drive Suite 330, Dayton, OH 45432 | 2020-04-23 |
| 1942833389 | Colleen Stevens | Counselor | 955 Sweeney Drive, Dayton, OH 45458 | 2020-02-13 |
| 1477190312 | Tewanna Hawkins | Counselor | 4352 Catalina Ave, Dayton, OH 45416-1302 | 2019-12-10 |
| 1588206718 | Iris Marie Blanchard | Counselor | 329 Imogene Rd, Dayton, OH 45405-5208 | 2019-10-09 |
| 1891345559 | Larry S Baxter IIi | Counselor | 612 Gramont Ave, Dayton, OH 45402-5439 | 2019-09-16 |
| 1992354286 | Eden E Mcdonald | Counselor | 1592 Joselin Rd, Dayton, OH 45432-3647 | 2019-09-09 |
| 1730746942 | Kimberly Billingsley | Counselor | 212 N Orchard Ave, Dayton, OH 45417-2453 | 2019-05-22 |
| Find all providers in DAYTON | ||||
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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.