MR. KENNETH DAYTON KRUEGER (NPI# 1780128934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780128934 |
| Entity Type | Individual |
| Full Name | MR. KENNETH DAYTON KRUEGER |
| Practice Address |
1942 E Cantrell St Decatur IL 62521-3214 |
| Practice Telephone | 2174236961 |
| Mailing Telephone | 2174236961 |
| Enumeration Date | 2016-12-07 |
| Last Update Date | 2016-12-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 370982024-002 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134132269 | Kenneth R. Krueger | Dentist | 4118 Mccullough Ave Ste 4, San Antonio, TX 78212-1905 | 2006-08-13 |
| 1538159231 | Kenneth J Krueger | Podiatrist | 4725 Statesmen Dr Ste A, Indianapolis, IN 46250-5645 | 2005-10-24 |
| Street Address |
1942 E CANTRELL ST |
| City | DECATUR |
| State | IL |
| Zip Code | 62521-3214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689633828 | Webster-cantrell Hall | Residential Treatment Facility, Emotionally Disturbed Children | 1942 E Cantrell St, Decatur, IL 62521-3214 | 2006-03-17 |
| 1841830429 | Webster Cantrell Youth Advocacy | Social Worker | 1942 E Cantrell St, Decatur, IL 62521-3214 | 2020-01-10 |
| 1366954489 | Denise Beeching | Counselor | 1942 E Cantrell St, Decatur, IL 62521-3214 | 2017-10-30 |
| 1699214379 | Monique Smith | Social Worker | 1942 E Cantrell St, Decatur, IL 62521-3214 | 2017-02-15 |
| 1427594357 | Brian Pinkston | Counselor | 1942 E Cantrell St, Decatur, IL 62521-3214 | 2017-01-17 |
| 1528421203 | Peter Hopkins | Counselor | 1942 E Cantrell St, Decatur, IL 62521-3214 | 2016-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| Find all providers in zip 62521 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043824014 | Magee Madry Counseling Services, LLC | Counselor | 2719 Apsley Way Sw, Decatur, AL 35603-3367 | 2020-09-07 |
| 1174141154 | Strong Counseling and Consulting | Counselor | 2107 N Decatur Rd Ste 711, Decatur, GA 30033-5305 | 2020-07-07 |
| 1982221917 | Jasmine Mcghee | Counselor | 2095 Manhattan Pkwy, Decatur, GA 30035-2252 | 2020-06-25 |
| 1851925218 | Nikkita Nelson | Counselor | 315 W Ponce De Leon Ave Ste 300, Decatur, GA 30030-2481 | 2020-02-25 |
| 1205476652 | Ameta Deborah Jasper | Counselor | 125 Clairemont Ave Ste 300, Decatur, GA 30030-2551 | 2020-01-14 |
| 1588208979 | Amanda Nesbitt | Counselor | 173 Pine Tree Cir, Decatur, GA 30032-1145 | 2019-10-29 |
| 1295386423 | Brentia J Caldwell | Counselor | 3205 River Shoals Cv, Decatur, GA 30034-6778 | 2019-09-29 |
| 1861044703 | Latasha Heinzen | Counselor | 2042 Beltline Rd Suite 120a, Decatur, AL 35602 | 2019-07-11 |
| 1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
| 1386107811 | Chardonnay Patterson | Counselor | 3629 Occidental Ct, Decatur, GA 30034-5502 | 2019-04-11 |
| Find all providers in DECATUR | ||||
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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.