LESSIE ELLEN LONG (NPI# 1811471592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811471592 |
| Entity Type | Individual |
| Full Name | LESSIE ELLEN LONG |
| Credential | CPS |
| Practice Address |
925 Highway V V Kennett MO 63857-3866 |
| Practice Telephone | 5733592600 |
| Mailing Telephone | 5733592600 |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2018-09-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
925 HIGHWAY V V |
| City | KENNETT |
| State | MO |
| Zip Code | 63857-3866 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316983463 | Eric Snipes | Counselor | 925 Highway V V, Kennett, MO 63857 | 2006-06-20 |
| 1497371975 | Kasey Marie Holifield | Peer Specialist | 925 Highway V V, Kennett, MO 63857-0071 | 2020-06-22 |
| 1548890577 | Autumn Flowers | Behavior Technician | 925 Highway V V, Kennett, MO 63857 | 2020-01-17 |
| 1730726019 | Brittany Elisabeth Axelson | Driver | 925 Highway V V, Kennett, MO 63857-0071 | 2019-12-05 |
| 1851957856 | Joleen Brege | Behavior Technician | 925 Highway V V, Kennett, MO 63857-0071 | 2019-05-15 |
| 1659836930 | David Eichler | Counselor | 925 Highway V V, Kennett, MO 63857-0071 | 2019-01-31 |
| 1720551377 | Heather Overton | Behavior Technician | 925 Highway V V, Kennett, MO 63857 | 2019-01-07 |
| 1780151795 | Angela Peters | Behavior Technician | 925 Highway V V, Kennett, MO 63857-0071 | 2018-10-29 |
| 1609355213 | Amanda Vazquez | Case Manager/Care Coordinator | 925 Highway V V, Kennett, MO 63857 | 2018-08-14 |
| 1174010995 | Taylor Rae Ellsworth | Licensed Practical Nurse | 925 Highway V V, Kennett, MO 63857 | 2018-04-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992278139 | Fancilla Adams | Counselor | 925 State Highway V V, Kennett, MO 63857 | 2019-01-10 |
| 1962994418 | Kiana Alexis Brown | Behavior Technician | 925 Highway W, Kennett, MO 63857 | 2018-05-31 |
| 1568953636 | Doctors Health Group, Inc | Family Medicine | 1312 First Street, Kennett, MO 63857 | 2018-05-24 |
| 1003328873 | Ann Graf | Counselor | 925 Vv, Kennett, MO 63857 | 2017-11-01 |
| 1457872160 | Jessica Luster | Technician, Other | 1109 Jones St., Kennett, MO 63857 | 2017-07-03 |
| 1235669128 | Chandra Celeste Perkins-shannon | Case Manager/Care Coordinator | 925 Hwy V, Kennett, MO 63857 | 2017-06-14 |
| 1467991612 | Sarah Lobdell | Case Manager/Care Coordinator | 925 State Highway Vv, Kennett, MO 63857 | 2017-02-21 |
| 1881132900 | Brandy Rios | Community Health Worker | 935 State Hwy Vv, Kennett, MO 63857 | 2017-02-09 |
| 1295272060 | Johnny Marie Johnson | Case Manager/Care Coordinator | 925 Hwy Vv Family Counseling Center, Kennett, MO 63857 | 2017-01-31 |
| 1043756364 | Heather Bowman | Case Manager/Care Coordinator | 875 Hwy Vv, Kennett, MO 63857 | 2017-01-10 |
| Find all providers in zip 63857 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366848855 | Rosanna Metcalf | Peer Specialist | 925 State Highway W, Kennett, MO 63857 | 2014-11-10 |
| 1497371975 | Kasey Marie Holifield | Peer Specialist | 925 Highway V V, Kennett, MO 63857-0071 | 2020-06-22 |
| 1932734829 | Erica Danielle Byes | Peer Specialist | 1075 Jones St, Kennett, MO 63857-3866 | 2020-03-11 |
| 1427680149 | Sonia Nicole Lay | Peer Specialist | 1075 Jones St, Kennett, MO 63857-3866 | 2020-02-11 |
| 1952958936 | Angela Marie Bevill | Peer Specialist | 1075 Jones St, Kennett, MO 63857-3866 | 2019-08-23 |
| 1053964478 | Tonya Renee Bridges | Peer Specialist | 925 Highway Vv, Kennett, MO 63857 | 2019-07-24 |
| 1649743980 | Allysha Ann Davis | Peer Specialist | 935 State Route Vv, Kennett, MO 63857-3822 | 2019-01-09 |
| 1346716362 | Perry Lynn Tucker | Peer Specialist | 875 State Route Vv, Kennett, MO 63857-9108 | 2018-10-17 |
| 1912488024 | Sarah Faith Brodeur | Peer Specialist | 925 Highway W, Kennett, MO 63857 | 2018-08-27 |
| 1669986071 | Tina R Winkle | Peer Specialist | 925 Highway V V, Kennett, MO 63857-0071 | 2017-11-21 |
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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.