SUSAN L JUNGEN (NPI# 1194811034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194811034 |
| Entity Type | Individual |
| Full Name | SUSAN L JUNGEN |
| Practice Address |
300 Crooks Street Green Bay WI 54305-2308 |
| Mailing Address |
300 Crooks Street Po Box 22308 Green Bay WI 54305-2308 |
| Practice Telephone | 9204366800 |
| Practice Fax Number | 9204325966 |
| Mailing Telephone | 9204366800 |
| Mailing Fax Number | 9204325966 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39314500 | 05 |
| Street Address |
300 CROOKS STREET |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54305-2308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972568608 | Judith M Hodel | Social Worker | 300 Crooks Street, Green Bay, WI 54301 | 2006-04-18 |
| 1417006370 | Lori Warchol | Social Worker | 300 Crooks Street, Green Bay, WI 54305-2308 | 2007-01-09 |
| 1740349166 | Kerri Marie Mcdermott | Case Manager/Care Coordinator | 300 Crooks Street, Green Bay, WI 54301 | 2006-12-08 |
| 1942387345 | Martha J Todd | Counselor | 300 Crooks Street, Green Bay, WI 54301 | 2006-11-01 |
| 1740367143 | Stephanie Lynn Adelman | Case Manager/Care Coordinator | 300 Crooks Street, Green Bay, WI 54301 | 2006-11-01 |
| 1821175225 | Marianne E Morris | Case Manager/Care Coordinator | 300 Crooks Street, Green Bay, WI 54301 | 2006-11-01 |
| 1164509576 | Houa D Yang | Case Manager/Care Coordinator | 300 Crooks Street, Green Bay, WI 54301 | 2006-11-01 |
| 1316023542 | Rachel Ann Monfils | Case Manager/Care Coordinator | 300 Crooks Street, Green Bay, WI 54301 | 2006-10-31 |
| 1043396278 | Mark Thomas Simonson | Case Manager/Care Coordinator | 300 Crooks Street, Green Bay, WI 54301 | 2006-10-31 |
| 1952487183 | Mary Meier | Case Manager/Care Coordinator | 300 Crooks Street, Green Bay, WI 54305-2308 | 2006-10-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326213976 | Sheila K Gohr | Counselor | 2945 Shawano Avenue, Green Bay, WI 54305 | 2008-04-24 |
| 1609203504 | Claire Mary Spahn | Pharmacist | 300 Pasteur Dr, Rm H0301, M/c 5616, Stanford, CA 54305 | 2013-10-09 |
| 1679667109 | Bel-regional Home Medical Inc | Pharmacy | 744 S Webster Ave, Green Bay, WI 54305 | 2006-10-02 |
| 1114448040 | Kimberly J Hoffman | Registered Nurse | Po Box 22425, Green Bay, WI 54305-2425 | 2017-06-30 |
| 1003986845 | Eric Maitland Dvorak | Physical Medicine & Rehabilitation | 744 S Webster Ave, Green Bay, WI 54305-2487 | 2006-11-09 |
| 1518903889 | Mary-clare Piontek | Pharmacist | 744 South Webster Ave, Green Bay, WI 54305-3400 | 2006-06-22 |
| 1396872909 | Mary B Fuss | Nurse Anesthetist, Certified Registered | 744 S Webster Ave, Green Bay, WI 54305-3400 | 2007-02-28 |
| 1619004025 | Mary J Debbout | Nurse Anesthetist, Certified Registered | 744 S Webster Ave, Green Bay, WI 54305-3400 | 2007-02-27 |
| 1922162593 | James Edward Talley | Nurse Anesthetist, Certified Registered | 744 S Webster Ave, Green Bay, WI 54305-3400 | 2006-12-20 |
| 1316263569 | Chris Edwin Anibal | Nurse Practitioner | 744 South Webster Avenue, Green Bay, WI 54305-3500 | 2010-04-13 |
| Find all providers in zip 54305 | ||||
| Taxonomy Code | 103TA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255408811 | Paul F Strand | Psychologist | 130 E Walnut St, Suite 706, Green Bay, WI 54301-4239 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023656162 | Dynamic Potential | Psychologist | 316 5th St Ste 2, Racine, WI 53403-4606 | 2019-12-19 |
| 1932312212 | Psychiatric & Psychotherapy Clinic L I Newman Md Sc Gen Ptr | Psychologist | 3601 30th Ave Ste 102, Kenosha, WI 53144-1642 | 2007-05-07 |
| 1154742880 | Larry E Taylor | Psychologist | 10532 N Port Washington Rd, Mequon, WI 53092-5563 | 2013-12-24 |
| 1790021897 | Brian Michael Flynn | Psychologist | 600 W Virginia St, Suite 203, Milwaukee, WI 53204-1500 | 2012-12-17 |
| 1821358185 | Henry Steinberger Phd LLC | Psychologist | 313 Price Pl, Suite 209, Madison, WI 53705-3262 | 2012-05-21 |
| 1043592173 | Andrew Wesley Kingwell | Psychologist | 500 E Veterans St, Tomah, WI 54660 | 2011-09-14 |
| 1285960518 | Craig D. Childs | Psychologist | 394 Williamstowne, Suite 202, Delafield, WI 53018-2322 | 2009-10-21 |
| 1114093929 | Fredrick O Beck | Psychologist | 2801 Calumet Dr, Sheboygan, WI 53083-3839 | 2006-11-27 |
| 1841242294 | Jo M Weis | Psychologist | 1155 North Mayfair Road, Behavioral Health Clinic @ Tosa, Milwaukee, WI 53226 | 2006-05-16 |
| 1346212545 | Ian R Powell | Psychologist | 34700 Valley Rd, Oconomowoc, WI 53066-4500 | 2006-02-02 |
| Find all providers with the same taxonomy | ||||
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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.