AINSLEY E. BLUM (NPI# 1811308836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811308836 |
| Entity Type | Individual |
| Full Name | AINSLEY E. BLUM |
| Other Name | AINSLEY E VANDYCK |
| Credential | LPC, SAC-IT |
| Practice Address |
301 E Saint Joseph St Green Bay WI 54301-2241 |
| Mailing Address |
Po Box 22040 Green Bay WI 54305-2040 |
| Practice Telephone | 9204336073 |
| Practice Fax Number | 9204310333 |
| Mailing Telephone | 9204457226 |
| Mailing Fax Number | 9204457229 |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2018-01-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
17069-130 | WI | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
WI | Behavioral Health & Social Service Providers | |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
1951-226 | WI | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
5863-125 | WI | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100037900 | 05 |
| Street Address |
301 E SAINT JOSEPH ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-2241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790775450 | Derek Carl Carlson | Psychiatry & Neurology | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2005-10-25 |
| 1407486541 | Gabrielle Cassandra Jochman | Social Worker | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2020-01-16 |
| 1457996910 | Jesse Frederick Peterson | Psychologist | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2019-11-08 |
| 1528500626 | Yasleny Rodriguez-castillo | Nurse Practitioner | 301 E Saint Joseph St, Green Bay, WI 54301 | 2016-11-07 |
| 1992156210 | Kari Lynn Mahlik | Nurse Practitioner | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2016-06-28 |
| 1710357900 | Erika Susanne Mangin | Registered Nurse | 301 E Saint Joseph St, Green Bay, WI 54301 | 2015-09-30 |
| 1972970572 | Kim Marie Smith | Counselor | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2015-08-31 |
| 1104200286 | Meghan A Thompson | Counselor | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2015-07-17 |
| 1720497118 | Mary Jo Vanden Wymelenberg | Counselor | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2014-08-11 |
| 1083039259 | Carrie B Ison | Counselor | 301 E Saint Joseph St, Green Bay, WI 54301-2241 | 2014-02-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760099329 | Spencer Rea Hansen Thomas | Counselor | 3340 Lineville Rd, Green Bay, WI 54313-7237 | 2020-09-28 |
| 1952914780 | Michelle Lee Barth | Counselor | 208 Longview Ave, Green Bay, WI 54301-1034 | 2020-08-31 |
| 1811412521 | Karlye Krien | Counselor | 1061 W Mason St, Green Bay, WI 54303-1858 | 2017-08-03 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1205387271 | Anne Karjala-dobbins | Counselor | 1985 E Telemark Cir, Green Bay, WI 54313-4335 | 2016-10-14 |
| 1689026650 | Catherine Calo | Counselor | 529 Greene Ave, Green Bay, WI 54301-2819 | 2016-07-01 |
| 1225498983 | Michael Sherman Fentress | Counselor | 2711 Humboldt Rd Apt 2, Green Bay, WI 54311-8463 | 2016-02-24 |
| 1831566363 | Stephanie Birmingham | Counselor | 1900 Morrow St, #106, Green Bay, WI 54302-3479 | 2015-09-01 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1700272929 | Kerri Schmidt | Counselor | 916 Willard Drive, Suite #136, Green Bay, WI 54304-6223 | 2015-04-14 |
| Find all providers in GREEN BAY | ||||
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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.