MR. JOSHUA DAVID GANDOLF (NPI# 1336171891) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336171891 |
| Entity Type | Individual |
| Full Name | MR. JOSHUA DAVID GANDOLF |
| Credential | CSAC |
| Practice Address |
1201 Tuckaway Ln Menasha WI 54952-1704 |
| Practice Telephone | 9207334277 |
| Mailing Telephone | 9207334277 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
14670 | WI | Behavioral Health & Social Service Providers |
| Street Address |
1201 TUCKAWAY LN |
| City | MENASHA |
| State | WI |
| Zip Code | 54952-1704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730339243 | Stacey R. Porterfield | Licensed Practical Nurse | 1201 Tuckaway Ln, Menasha, WI 54952-1704 | 2008-09-22 |
| 1003937228 | Diane M Coats | Licensed Practical Nurse | 1201 Tuckaway Ln, Menasha, WI 54952-1704 | 2007-04-03 |
| 1003950965 | Michael G. Frost | Counselor | 1201 Tuckaway Ln, Menasha, WI 54952-1704 | 2007-02-16 |
| 1699816165 | Cynthia A. Griese | Counselor | 1201 Tuckaway Ln, Menasha, WI 54952-1704 | 2007-02-09 |
| 1558401307 | Donald Oftedahl | Counselor | 1201 Tuckaway Ln, Menasha, WI 54952-1704 | 2007-02-08 |
| 1871631242 | Kerri L Heegeman | Counselor | 1201 Tuckaway Ln, Menasha, WI 54952-1704 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275776239 | Sharon Louise Crowe | Dental Hygienist | 1814 North Appleton Road, Menasha, WI 54952 | 2009-04-07 |
| 1003056110 | Nicole Marie Guyette | Dental Hygienist | 814 N. Appleton Road, Menasha, WI 54952 | 2009-03-02 |
| 1760627624 | Jan Charles Sarnecki | Orthopaedic Surgery | 1814 N. Appleton Road, Menasha, WI 54952 | 2008-12-08 |
| 1588828297 | Lesley R Lathrop | Registered Nurse | 1764 Oakridge Court, Menasha, WI 54952 | 2008-07-11 |
| 1699965137 | Lisa Randerson | Counselor | 1427c Province Terrace, Menasha, WI 54952 | 2007-07-31 |
| 1689748675 | Lisa Lynn Lang Riegel | Dentist | 1155 Wittman Drive, Menasha, WI 54952 | 2006-11-20 |
| 1164596144 | Robert Charles Lang | Dentist | 1155 Wittmann Drive, Menasha, WI 54952 | 2006-11-20 |
| 1366527947 | Karen Patricia Schmidt | Case Manager/Care Coordinator | 1810 Appleton Road, Menasha, WI 54952 | 2006-10-25 |
| 1376647388 | Goodwill Industries of North Central Wi | Counselor | 1800 Appleton Road, Menasha, WI 54952 | 2006-09-11 |
| 1386135614 | Leslie J Steckbauer | Counselor | 1095 Midway Rd, Menasha, WI 54952 | 2018-05-22 |
| Find all providers in zip 54952 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811438104 | Kimberly Williams-nyberg | Counselor | 1107 Stillmeadow Ln, Menasha, WI 54952-3506 | 2017-03-20 |
| 1285050294 | Catherine Gray | Counselor | 1478 Kenwood Dr Ste D1, Menasha, WI 54952-1161 | 2014-03-14 |
| 1699965137 | Lisa Randerson | Counselor | 1427c Province Terrace, Menasha, WI 54952 | 2007-07-31 |
| 1073164307 | Betty J Atchison | Counselor | 1095 Midway Rd, Menasha, WI 54952-1115 | 2019-09-27 |
| 1346718749 | Greg A Delaney | Counselor | 1095 Midway Rd, Menasha, WI 54952-1115 | 2018-11-05 |
| 1841776192 | Margaret Ann Gehrke | Counselor | 130 Main St Ste 200, Menasha, WI 54952-3181 | 2018-07-18 |
| 1386135614 | Leslie J Steckbauer | Counselor | 1095 Midway Rd, Menasha, WI 54952 | 2018-05-22 |
| 1801395264 | Jill M Goldstein | Counselor | 1095 Midway Rd, Menasha, WI 54952-1115 | 2018-02-12 |
| 1124539713 | Laura M John | Counselor | 1095 Midway Rd, Menasha, WI 54952-1115 | 2017-10-23 |
| 1467989251 | Nicole M Hooley | Counselor | 1095 Midway Rd, Menasha, WI 54952-1115 | 2017-05-11 |
| Find all providers in MENASHA | ||||
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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.