JACQUELINE J. PETTY (NPI# 1922060839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922060839 |
| Entity Type | Individual |
| Full Name | JACQUELINE J. PETTY |
| Credential | LCPC |
| Practice Address |
304 8th St Lincoln IL 62656-2658 |
| Mailing Address |
710 N 8th St Springfield IL 62702-6324 |
| Practice Telephone | 2177352272 |
| Practice Fax Number | 2177329847 |
| Mailing Telephone | 2175251064 |
| Mailing Fax Number | 2175251651 |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
IL | Behavioral Health & Social Service Providers |
| Street Address |
304 8TH ST |
| City | LINCOLN |
| State | IL |
| Zip Code | 62656-2658 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841259819 | Mary E. Smith | Registered Nurse | 304 8th St, Lincoln, IL 62656-2658 | 2006-03-20 |
| 1376765131 | Christina A Ward | Counselor | 304 8th St, Lincoln, IL 62656-2658 | 2007-05-02 |
| 1588793665 | Millicent L. Bliesener | Counselor | 304 8th St, Lincoln, IL 62656-2658 | 2007-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437678943 | Carissa Jo O'donoghue | Speech-Language Pathologist | 1000 Railer Way, Lincoln, IL 62656 | 2017-09-15 |
| 1083972012 | Cynthia Dorchinecz | Speech-Language Pathologist | 200 Fifth Street, Lincoln, IL 62656 | 2012-04-27 |
| 1104100114 | Jan E Fehrenbacher | Pharmacist | 603 Woodlawn, Lincoln, IL 62656 | 2011-10-10 |
| 1053633263 | Tazwood Mental Health Center, Inc. | Community/Behavioral Health | 124-126 S. Chicago Street, Lincoln, IL 62656 | 2010-02-16 |
| 1649428756 | Diane E Ulrich | Dentist | 400 N. Chicago St, Lincoln, IL 62656 | 2008-09-03 |
| 1922202944 | Robert C Miller | Dentist | 217 S Kickapoo St, Lincoln, IL 62656 | 2007-06-13 |
| 1720290638 | Lifetime Dental Care of Illinois, PC | Dentist | 411 Keokuk Street, Lincoln, IL 62656 | 2007-05-04 |
| 1982734539 | Wal-mart Stores, Inc. Dba Wal-mart | Technician/Technologist | 825 Malerich Dr., Lincoln, IL 62656 | 2007-03-06 |
| 1861571663 | David R Hepler II | Chiropractor | 2000 Pulaski Street, Lincoln, IL 62656 | 2006-11-03 |
| 1477561793 | Raymond Todd Nobbe | Optometrist | 1400 Woodlawn Road, Lincoln, IL 62656 | 2006-08-03 |
| Find all providers in zip 62656 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410533 | Anne Tapley, Ph.d., LLC | Counselor | 3801 Union Drive, Ste 206, Lincoln, NE 68516-6652 | 2020-09-01 |
| 1770195018 | Jolie Vega | Counselor | 8101 O St # S300, Lincoln, NE 68510-2646 | 2020-08-18 |
| 1366067068 | Alternative Avenues & Associates | Counselor | 4740 A St Ste 200, Lincoln, NE 68510-4824 | 2020-06-09 |
| 1689295560 | Mary Kay Wood, LLC | Counselor | 3611 Lowell Ave, Lincoln, NE 68506-4848 | 2020-05-01 |
| 1013540673 | Unity Youth & Family Services, LLC | Counselor | 6245 Windhaven Drive, Lincoln, NE 68512 | 2020-02-21 |
| 1336786565 | Jessica Schwartz | Counselor | 5 Old Cambridge Tpke, Lincoln, MA 01773-1804 | 2019-12-06 |
| 1518504182 | Positive Perspectives, PC | Counselor | 200 W F St, Lincoln, NE 68508-2964 | 2019-12-03 |
| 1922641471 | Kristine Anne Pothast | Counselor | 2120 S 56th St Ste 206, Lincoln, NE 68506-2118 | 2019-10-28 |
| 1841833019 | Chelsea Schutter | Counselor | 4747 Pioneers Blvd # 10d, Lincoln, NE 68506-5313 | 2019-10-21 |
| 1174180673 | Lisa Fern Mischke | Counselor | 1240 N 10th St, Lincoln, NE 68508-1125 | 2019-05-21 |
| Find all providers in LINCOLN | ||||
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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.