MS. JODY PETZOLDT (NPI# 1689941528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689941528 |
| Entity Type | Individual |
| Full Name | MS. JODY PETZOLDT |
| Credential | M.A. |
| Practice Address |
340 S Broadview St Cape Girardeau MO 63703-5703 |
| Practice Telephone | 5733320416 |
| Practice Fax Number | 5733352698 |
| Mailing Telephone | 5733320416 |
| Mailing Fax Number | 5733352698 |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2011-11-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
2011036260 | MO | Behavioral Health & Social Service Providers |
| Street Address |
340 S BROADVIEW ST |
| City | CAPE GIRARDEAU |
| State | MO |
| Zip Code | 63703-5703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598909939 | Janice L Ruesler | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2009-04-29 |
| 1750886909 | Mechelle Abernathy | Licensed Practical Nurse | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2018-03-29 |
| 1659879096 | Tina Fuller | Licensed Practical Nurse | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2018-01-31 |
| 1386152973 | Brenda Gause | Registered Nurse | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2018-01-17 |
| 1679928501 | Gibson Recovery Center, Inc. | Clinic/Center | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2016-04-28 |
| 1669803540 | Center for Relationship Recovery and Counseling | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2013-12-03 |
| 1093097917 | Mary Ann Roberston | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2011-09-16 |
| 1164719373 | Gibson Recovery Center, Inc. | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2011-07-08 |
| 1316232069 | John Eugene Nimmo | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2011-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720566102 | Christian Torres Diaz | Dentist | 3070 William Street, Cape Girardeau, MO 63703 | 2018-07-30 |
| 1457758153 | Broadway Ltc, LLC | Pharmacy | 37 Doctors Park Ste 7, Cape Girardeau, MO 63703 | 2014-11-24 |
| 1336562263 | Rachel Speer | Community Health Worker | 20 South Sprigg St, Cape Girardeau, MO 63703 | 2014-01-29 |
| 1245653120 | Mary Wilburn | Community Health Worker | 20 S Spigg, Cape Girardeau, MO 63703 | 2014-01-28 |
| 1831523695 | Saint Francis Medical Center | General Acute Care Hospital | 150 South Mount Auburn Road, Suite 342, Cape Girardeau, MO 63703 | 2013-08-29 |
| 1033481163 | J K Essmyer Medical Services LLC | Clinic/Center | 300 Mt Auburn Rd, Auburn Surgery Center, Inc, Cape Girardeau, MO 63703 | 2012-02-06 |
| 1477867844 | Drx - East Missouri Providers, P.C. | Family Medicine | 465 S Mount Auburn Road, Suite 103, Cape Girardeau, MO 63703 | 2010-07-28 |
| 1346564879 | Richard William Tobey | Family Medicine | 3250 Gordonville Rd Ste 301, Cape Girardeau, MO 63703 | 2010-03-26 |
| 1144413568 | Stephanie Danette Miller | Family Medicine | 817 S. Mount Auburn, Suite 100, Southeast Primary Care, Cape Gerardeau, MO 63703 | 2007-08-20 |
| 1437349305 | Shanaree Mae Muzinich | Radiology | 70 Doctor's Park, Cape Girardeau, MO 63703 | 2007-07-27 |
| Find all providers in zip 63703 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073012217 | Dale & Associates | Counselor | 2846 Professional Ct, Cape Girardeau, MO 63703-5035 | 2018-02-02 |
| 1679939086 | Samuel Hite | Counselor | 1025 N. Sprigg, Cottonwood Residential Treatment Center, Cape Girardeau, MO 63701-4831 | 2016-01-14 |
| 1205246634 | John Coffee | Counselor | 2935 Lynwood Hills Dr, Cape Girardeau, MO 63701-8408 | 2014-05-07 |
| 1891137071 | Dale and Hancock Center LLC | Counselor | 528 Helena St, Cape Girardeau, MO 63701-5133 | 2013-07-29 |
| 1285932855 | Jennifer Lauren Nelson | Counselor | 1 University Plz # Ms 3333, Southeast Missouri State University, Cape Girardeau, MO 63701-4710 | 2011-03-07 |
| 1598909939 | Janice L Ruesler | Counselor | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2009-04-29 |
| 1508036260 | Shawna R Legrand | Counselor | 402 S Silver Sprng Rd, Cape Girardeau, MO 63703-7536 | 2008-03-08 |
| 1528265956 | Michelle Dean Wagner | Counselor | 833 Broadway St, Suite 103, Cape Girardeau, MO 63701-5515 | 2007-06-29 |
| 1750597514 | Felicia Kennedy | Counselor | 815 N Fountain St, Cape Girardeau, MO 63701-7201 | 2007-05-15 |
| 1659448785 | Beverly Gore Stott | Counselor | 2917 Park West Hts, Cape Girardeau, MO 63703-5005 | 2006-11-30 |
| Find all providers in CAPE GIRARDEAU | ||||
| City | CAPE GIRARDEAU |
| Zip Code | 63703 |
Please comment or provide details below to improve the information on MS. JODY PETZOLDT.
| 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.