DR. MIKELL RYANNE EHNLE (NPI# 1780973925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780973925 |
| Entity Type | Individual |
| Full Name | DR. MIKELL RYANNE EHNLE |
| Credential | PSYD |
| Practice Address |
3716 W Brighton Ave Peoria IL 61615-2938 |
| Mailing Address |
2300 S Main St Apt C Eureka IL 61530-1633 |
| Practice Telephone | 3096927755 |
| Mailing Telephone | 8478480203 |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2018-09-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 071.008074 | IL | Behavioral Health & Social Service Providers |
| Street Address |
3716 W BRIGHTON AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-2938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568434306 | Sarah Katherine Holland | Counselor | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2006-02-06 |
| 1427612464 | Morris Daniel Lee | Counselor | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2019-04-25 |
| 1467802090 | Jennifer Morrison | Counselor | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2016-06-14 |
| 1942557525 | Bethany Vanne | Counselor | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2012-08-13 |
| 1861699472 | David Christopher Weidner | Psychologist | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2007-06-27 |
| 1568689511 | Ruth Ann Jennings | Social Worker | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2007-04-19 |
| 1326199407 | Jacqueline Lee Clemons | Social Worker | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2007-01-15 |
| 1013974765 | John Richard Day | Psychologist | 3716 W Brighton Ave, Peoria, IL 61615 | 2006-04-27 |
| 1255396347 | Phillip J Ladd | Counselor | 3716 W Brighton Ave, Peoria, IL 61615 | 2006-04-20 |
| 1013972082 | Donna Jaree Brooks | Counselor | 3716 W Brighton Ave, Peoria, IL 61615-2938 | 2006-04-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508026865 | Eckert & Associates | Psychologist | 3024 W Lake Avenue, Peoria, IL 61615 | 2008-06-11 |
| 1972604411 | Glen Manor Counseling | Psychologist | 914 Glen Ave, Suite #3, Peoria, IL 61614 | 2006-09-26 |
| 1801993142 | The Antioch Group, Inc. | Psychologist | 6615 N. Big Hollow Rd., Peoria, IL 61615-2451 | 2006-09-20 |
| 1326024332 | Greg Alan Peetoom | Psychologist | 20470 N Lake Pleasant Rd Ste 106, Peoria, AZ 85382 | 2005-12-21 |
| 1265948863 | Del Soul Counseling Pllc | Psychologist | 15396 N 83rd Ave Ste G103, Peoria, AZ 85381-5629 | 2017-12-18 |
| 1699848051 | Regina Mae Tinio Kabatay Brian | Psychologist | 900 Main Street, Suite 780, Peoria, IL 61602 | 2006-11-15 |
| 1093894248 | Anthony Perino | Psychologist | 7317 N Willow Lake Ct, Peoria, IL 61614-8260 | 2006-11-06 |
| 1629157987 | Shelley Falkin Gregg | Psychologist | 7317 N Willow Lake Ct, Peoria, IL 61614-8260 | 2006-11-06 |
| 1710066980 | Eric Ward | Psychologist | 7317 N Willow Lake Ct, Peoria, IL 61614-8260 | 2006-11-06 |
| 1932288289 | Robert Glazeski | Psychologist | 7317 N Willow Lake Ct, Peoria, IL 61614-8260 | 2006-11-06 |
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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.