Tasha L Wisdom (NPI# 1730450156, PAC ID# 6608193651) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CLINICAL SOCIAL WORKER.
| Nation Provider ID (NPI) | 1730450156 |
| PAC ID by PECOS | 6608193651 |
| Professional Enrollment ID | I20150331002659 |
| Full Name | Tasha L Wisdom |
| Organization Legal Name | FAMILY COUNSELING CENTER INC |
| Address |
315 E Walnut St Ellington MO 63638-7943 |
| Phone Number | 5736632644 |
| Gender | F |
| Graduation Year | 2011 |
| Primary Specialty | CLINICAL SOCIAL WORKER |
| Group Practice PAC ID | 2163410481 |
| Number of Group Practice Members | 20 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 315 E Walnut St, Ellington, MO 63638-7943 | 5736632644 | FAMILY COUNSELING CENTER INC |
| 925 Hwy Vv, Kennett, MO 63857-0071 | 5738885925 | FAMILY COUNSELING CENTER INC |
| Bldg 925 Hwy Vv, Kennett, MO 63857-0071 | 5738885925 | FAMILY COUNSELING CENTER INC |
| 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 5736861200 | FAMILY COUNSELING CENTER INC |
| Organization Legal Name | FAMILY COUNSELING CENTER INC |
| Physicians | 25 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Whitney J Bradford | Nurse Practitioner | Family Counseling Center Inc | 900 State Route Vv, Kennett, MO 63857-3834 |
| Andrea C Jasdanwala | Nurse Practitioner | Family Counseling Center Inc | 500 Hwy J, Hayti, MO 63851-1200 |
| Juanita J Buchanan | Clinical Social Worker | Family Counseling Center Inc | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 |
| Teresa L Brasher | Clinical Social Worker | Family Counseling Center Inc | 925 Hwy Vv, Kennett, MO 63857-0071 |
| Mark R Thelen | Psychologist, Clinical | Family Counseling Center Inc | 102 Marty Dr, Buffalo, MN 55313-9305 |
| Susan G Helms | Clinical Social Worker | Family Counseling Center Inc | Bldg 925 Hwy Vv, Kennett, MO 63857-0071 |
| Craig E Tatom | Nurse Practitioner | Family Counseling Center Inc | 20 S Sprigg St, Cape Girardeau, MO 63703-6212 |
| Brenda J Gray | Clinical Social Worker | Family Counseling Center Inc | 925 Hwy Vv, Kennett, MO 63857-0071 |
| Clea M Fairaizl | Clinical Social Worker | Family Counseling Center Inc | 925 Hwy Vv, Kennett, MO 63857-0071 |
| Larina J Ditto | Clinical Social Worker | Family Counseling Center Inc | 925 Hwy Vv, Kennett, MO 63857-0071 |
| Street Address |
315 E WALNUT ST |
| City | ELLINGTON |
| State | MO |
| Zip | 63638-7943 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Terra Renee Graves | Clinical Social Worker | Big Springs Medical Association | 61 Hwy Y, Ellington, MO 63638-7802 |
| Joseph C.f. Camire | Family Medicine | Big Springs Medical Association | 61 Hwy Y, Ellington, MO 63638-7802 |
| Judith A Medley | Nurse Practitioner | Big Springs Medical Association | 61 Hwy Y, Ellington, MO 63638-7802 |
| Susan Marie Norris | Nurse Practitioner | Big Springs Medical Association | 61 Hwy Y, Ellington, MO 63638-7802 |
| Amy Lee Manning | Nurse Practitioner | Big Springs Medical Association | 61 Hwy Y, Ellington, MO 63638-7802 |
| John Mccormack | General Practice | Big Springs Medical Association | 61 Hwy Y, Ellington, MO 63638-7802 |
| Tammy J Lindsay | Family Medicine | Big Springs Medical Association | 61 Hwy Y, Ellington, MO 63638-7802 |
| Loretta Baker-montgomery | Clinical Social Worker | Big Springs Medical Association | 110 S 2nd St, Ellington, MO 63638-9400 |
| City | ELLINGTON |
| Zip Code | 63638 |
| Specialty | CLINICAL SOCIAL WORKER |
| City + Specialty | ELLINGTON + CLINICAL SOCIAL WORKER |
Please comment or provide details below to improve the information on Tasha L Wisdom.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.