TONYA MARIE MARAVILLA (NPI# 1417585498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417585498 |
| Entity Type | Individual |
| Full Name | TONYA MARIE MARAVILLA |
| Credential | APSS |
| Practice Address |
413 E Dixie Ave Ste 106 Elizabethtown KY 42701-1162 |
| Practice Telephone | 2703199899 |
| Mailing Telephone | 2703199899 |
| Mailing Fax Number | 2703053253 |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2020-03-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | 1170044 | KY | Other Service Providers |
| Street Address |
413 E DIXIE AVE STE 106 |
| City | ELIZABETHTOWN |
| State | KY |
| Zip Code | 42701-1162 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962023879 | Brian Timothy Long | Counselor | 413 E Dixie Ave Ste 106, Elizabethtown, KY 42701-1162 | 2020-05-01 |
| 1891323010 | Velma J. Jackson | Counselor | 413 E Dixie Ave Ste 106, Elizabethtown, KY 42701-1162 | 2020-04-01 |
| 1417585621 | Michelle Lynn Dubberke | Counselor | 413 E Dixie Ave Ste 106, Elizabethtown, KY 42701-1162 | 2020-04-01 |
| 1306474739 | Natasha H Compton | Peer Specialist | 413 E Dixie Ave Ste 106, Elizabethtown, KY 42701-1162 | 2020-03-31 |
| 1386272623 | Rhonda Harris | Peer Specialist | 413 E Dixie Ave Ste 106, Elizabethtown, KY 42701-1162 | 2020-03-31 |
| 1255969614 | Julia C Holeman | Peer Specialist | 413 E Dixie Ave Ste 106, Elizabethtown, KY 42701-1162 | 2020-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693104 | James G. Thornton | Specialist/Technologist, Other | 2409 Ring Road, Suite 106, Elizabethtown, KY 42701 | 2020-09-11 |
| 1033720727 | Rebecca Williams | Pharmacist | 1602 N Dixie Highway, Elizabethtown, KY 42701 | 2020-08-14 |
| 1245855709 | Mckenzie Jo Clemons | Speech-Language Pathologist | 107 Financial Drive, Elizabethtown, KY 42701 | 2020-06-10 |
| 1215565825 | Christina Nichole Hobson | Peer Specialist | 413 E Dixie Ste 106, Elizabethtown, KY 42701 | 2020-03-30 |
| 1336701275 | Cassandra Elizabeth Baker | Nurse Practitioner | 2005 N. Dixie Highway, Elizabethtown, KY 42701 | 2019-07-01 |
| 1487134276 | Ryan Leon Hogan | Marriage & Family Therapist | 1106 Tunnel Hill Road, Suite 100, Elizabethtown, KY 42701 | 2018-08-21 |
| 1033623921 | Kayla Russell | Behavior Technician | 529 Westport Road, Elizabethtown, KY 42701 | 2017-11-30 |
| 1578087128 | Brenda Gale Nunn | Case Manager/Care Coordinator | 2600 Ring Road, Elizabethtown, KY 42701 | 2017-07-26 |
| 1013451277 | Chelsea Danielle Thorn | Nurse Practitioner | 2005 N. Dixie Hwy, Elizabethtown, KY 42701 | 2016-12-07 |
| 1003364597 | Joseph Michael Senay | Pharmacist | 521 Robinbrooke Dr., Cancer Care Center of Hardin Memorial Hospital, Elizabethtown, KY 42701 | 2016-09-14 |
| Find all providers in zip 42701 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881291672 | W I N G S Community Support & Recovery Services | Peer Specialist | 401 N Miles St # B101, Elizabethtown, KY 42701-1834 | 2020-10-05 |
| 1427671957 | Barbara K Collier | Peer Specialist | 205 Mercer St, Elizabethtown, KY 42701-2731 | 2020-05-19 |
| 1497383715 | Lawerence E Pickett | Peer Specialist | 537 Bellwood Dr, Elizabethtown, KY 42701-2336 | 2020-03-31 |
| 1326676578 | April Roann Robertson | Peer Specialist | 207 Hillcrest Dr, Elizabethtown, KY 42701-1719 | 2020-03-31 |
| 1053949370 | Brad Williamson | Peer Specialist | 535 Bellwood Dr Apt 1, Elizabethtown, KY 42701-2335 | 2020-03-31 |
| 1730717000 | Carolyn M Vance | Peer Specialist | 537 Bellwood Dr Apt 1, Elizabethtown, KY 42701-2336 | 2020-03-31 |
| 1083242697 | Chelsea Blair | Peer Specialist | 413 E Dixie Ave, Elizabethtown, KY 42701-1162 | 2020-03-30 |
| 1215565825 | Christina Nichole Hobson | Peer Specialist | 413 E Dixie Ste 106, Elizabethtown, KY 42701 | 2020-03-30 |
| 1619506748 | Randall Scott Vance | Peer Specialist | 537 Bellwood Dr Apt 1, Elizabethtown, KY 42701-2336 | 2020-04-01 |
| 1548898976 | Emily Bell | Peer Specialist | 413 E Dixie Ave, Elizabethtown, KY 42701-1162 | 2020-03-31 |
| Find all providers in ELIZABETHTOWN | ||||
| City | ELIZABETHTOWN |
| Zip Code | 42701 |
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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.