JESSICA GOETHALS (NPI# 1649836271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649836271 |
| Entity Type | Individual |
| Full Name | JESSICA GOETHALS |
| Practice Address |
955 Campus Dr N Waterford MI 48328-2754 |
| Mailing Address |
1034 Great Oaks Blvd Rochester MI 48307-1022 |
| Practice Telephone | 2484756300 |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2019-05-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
955 CAMPUS DR N |
| City | WATERFORD |
| State | MI |
| Zip Code | 48328-2754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194254029 | Pamela Ann Jeremias | Social Worker | 955 Campus Dr N, Waterford, MI 48328-2754 | 2017-06-05 |
| 1417557166 | Nicholas Ruddy | Behavior Technician | 955 Campus Dr N, Waterford, MI 48328-2754 | 2020-10-30 |
| 1417557810 | Emily Grace Maxwell | Case Manager/Care Coordinator | 955 Campus Dr N, Waterford, MI 48328-2754 | 2020-10-27 |
| 1730791716 | Morgan Marie Bass | Behavior Technician | 955 Campus Dr N, Waterford, MI 48328-2754 | 2020-08-20 |
| 1992316269 | Carolyn Meador | Case Manager/Care Coordinator | 955 Campus Dr N, Waterford, MI 48328-2754 | 2020-08-11 |
| 1598376998 | Brianna Adler | Case Manager/Care Coordinator | 955 Campus Dr N, Waterford, MI 48328-2754 | 2020-08-11 |
| 1255966834 | Lorren Roberts | Behavior Technician | 955 Campus Dr N, Waterford, MI 48328-2754 | 2020-03-04 |
| 1679106694 | Karissa Ritthaler | Case Manager/Care Coordinator | 955 Campus Dr N, Waterford, MI 48328-2754 | 2020-02-18 |
| 1063054526 | Kaele Polzin | Assistant Behavior Analyst | 955 Campus Dr N, Waterford, MI 48328-2754 | 2019-10-16 |
| 1568010486 | Ksenia Zakharova | Assistant Behavior Analyst | 955 Campus Dr N, Waterford, MI 48328-2754 | 2019-09-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477184125 | Lillian Atty | Pharmacist | 1484 Rivona Dr, Waterford, MI 48328 | 2020-01-31 |
| 1437631850 | Rana Ismail | Pharmacist | 3273 West Huron St, Waterford, MI 48328 | 2018-09-01 |
| 1588181978 | India Dunlap | Social Worker | 279 Summit Dr., Waterford, MI 48328 | 2017-08-25 |
| 1689191280 | Sydney Strandberg | Social Worker | 1145 Parkway, Waterford, MI 48328 | 2017-08-24 |
| 1467982074 | Briana Greenlee | Dietitian, Registered | 3819 Faber Terrace, Waterford, MI 48328 | 2017-06-15 |
| 1922537364 | Lourdes Alzheimer's Special Care | Custodial Care Facility | 2400 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1013446459 | Lourdes Assisted Living | Assisted Living Facility | 2450 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1588019053 | Legacy Dermatology Group PC | Dermatology | 1392 S Cass Lake Rd, Waterford, MI 48328 | 2016-05-03 |
| 1932567989 | Devenia Denise Clayter | Counselor | 255 Summit Dr, Waterford, MI 48328 | 2016-02-05 |
| 1922409739 | Stacey Diggs | Counselor | 250 Elizabeth Lake Road, Biomed Behavorial Healthcare, Waterford, MI 48328 | 2014-09-11 |
| Find all providers in zip 48328 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326608811 | Eriel Negron | Case Manager/Care Coordinator | 4957 Oak Hill Dr, Waterford, MI 48329-1752 | 2019-06-17 |
| 1942664826 | Julie Stinson | Case Manager/Care Coordinator | 2587 Lovington Ln, Waterford, MI 48329-3375 | 2016-04-07 |
| 1477935591 | Stacey Diamond | Case Manager/Care Coordinator | 931 Williamsbury Apt 333, Waterford, MI 48328-2265 | 2015-06-25 |
| 1477994408 | Carol Berousek | Case Manager/Care Coordinator | 6270 Barker Dr, Waterford, MI 48329-3181 | 2013-07-05 |
| 1780022095 | Rebecca Swain | Case Manager/Care Coordinator | 3460 Clayton Ave, Waterford, MI 48329-3206 | 2013-06-08 |
| 1467616136 | Barry Jenneman | Case Manager/Care Coordinator | 1365 Shoman St, Waterford, MI 48327-1862 | 2008-07-11 |
| 1417557810 | Emily Grace Maxwell | Case Manager/Care Coordinator | 955 Campus Dr N, Waterford, MI 48328-2754 | 2020-10-27 |
| 1992316269 | Carolyn Meador | Case Manager/Care Coordinator | 955 Campus Dr N, Waterford, MI 48328-2754 | 2020-08-11 |
| 1598376998 | Brianna Adler | Case Manager/Care Coordinator | 955 Campus Dr N, Waterford, MI 48328-2754 | 2020-08-11 |
| 1679106694 | Karissa Ritthaler | Case Manager/Care Coordinator | 955 Campus Dr N, Waterford, MI 48328-2754 | 2020-02-18 |
| Find all providers in WATERFORD | ||||
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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.