JANE SUSANN BRENNEKE (NPI# 1013268911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013268911 |
| Entity Type | Individual |
| Full Name | JANE SUSANN BRENNEKE |
| Credential | MS, LPC |
| Practice Address |
116 B 2nd Street Desoto MO 63020 |
| Mailing Address |
9928 Thurman Oaks Rd Valles Mines MO 63087-1324 |
| Practice Telephone | 6362499993 |
| Mailing Telephone | 6362499993 |
| Mailing Fax Number | 6362433903 |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
2012024498 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1013268911 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 309 Garrett St, Fredericktown, MO 636451084 | 5732381027 | 5736514345 |
| 9928 Thurman Oaks Rd, Valles Mines, MO 630871324 | 6362499993 | 6362433903 |
| Street Address |
116 B 2ND STREET |
| City | DESOTO |
| State | MO |
| Zip Code | 63020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700435385 | Patsy Maness | Technician | 5100 Knorpp Road, De Soto, MO 63020 | 2019-09-06 |
| 1477634277 | Wal-mart Stores East, Lp | Technician/Technologist | 12862 State Road 21, De Soto, MO 63020 | 2006-10-18 |
| 1235109877 | John W Dickinson | Dentist | 704 N Main Street, Desoto, MO 63020 | 2006-01-25 |
| 1700883253 | Valle Ambulance District | Ambulance | 12363 State Route 21, De Soto, MO 63020 | 2005-06-30 |
| 1568893105 | Terence A. Friskel | Dentist | 110 North Main, Desoto, MO 63020 | 2013-12-09 |
| 1457541427 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 12977 State Route 21, De Soto, MO 63020-1000 | 2007-07-26 |
| 1982880084 | Thomas L. Monje, O.d. | Optometrist | 26 Jefferson Sq, De Soto, MO 63020-1031 | 2008-01-18 |
| 1548266737 | Steven Crawford | Family Medicine | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2005-06-22 |
| 1720595200 | Danielle Marie Howerton | Nurse Practitioner | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2018-01-05 |
| 1033652862 | Michelle Mick | Nurse Practitioner | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2016-11-28 |
| Find all providers in zip 63020 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780297770 | John Nweke | Counselor | 1229 E Pleasant Run Rd Ste 200, Desoto, TX 75115-4214 | 2020-08-28 |
| 1316562275 | Allison Moore | Counselor | 510 Shennandoah Dr, Desoto, TX 75115-2941 | 2020-06-16 |
| 1750946216 | Sheba Vical Hamilton | Counselor | 1604 Bramble Creek Dr, Desoto, TX 75115-1733 | 2019-05-09 |
| 1356904932 | An Inspired Hope Counseling Pllc | Counselor | 1510 N Hampton Rd Ste 220, Desoto, TX 75115-8301 | 2019-04-18 |
| 1679072193 | Rogelio Manuel Velazquez | Counselor | 1007 N Cockrell Hill Rd, Desoto, TX 75115-2717 | 2018-02-10 |
| 1124534888 | Herlonda Dotson | Counselor | 620 Candelila Drive, Desoto, TX 75115 | 2017-12-18 |
| 1366965659 | Leon A. Maryland | Counselor | 413 Rainier Street, Desoto, TX 75115 | 2017-07-19 |
| 1326403981 | Oran L. Pryor Ma, Lpc | Counselor | 104 Spinner Rd, Desoto, TX 75115-4430 | 2015-12-28 |
| 1679975494 | Cleveland Jones Jr. | Counselor | 629 Gardenia St, Desoto, TX 75115-1450 | 2014-09-24 |
| 1568861730 | Kaiesha L. Flucas | Counselor | 1229 E Pleasant Run Rd Ste 305, Desoto, TX 75115-4229 | 2014-08-13 |
| Find all providers in DESOTO | ||||
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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.