JEANINE STANDARD METAMORPHOSIS INC (NPI# 1427401504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427401504 |
| Entity Type | Organization |
| Organization Name | JEANINE STANDARD METAMORPHOSIS INC |
| Practice Address |
8 S Main St Suite 205 Canton IL 61520-2677 |
| Practice Telephone | 3097402171 |
| Practice Fax Number | 3097402171 |
| Mailing Telephone | 3097402171 |
| Mailing Fax Number | 3097402171 |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2016-07-13 |
| Authorized Official Name | DR. JEANINE RENE STANDARD (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Telephone | 3097402171 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071.007101 | IL | Behavioral Health & Social Service Providers |
| Street Address |
8 S MAIN ST SUITE 205 |
| City | CANTON |
| State | IL |
| Zip Code | 61520-2677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275655698 | Nathan W Gates | Counselor | 8 S Main St, Suite 203, Canton, IL 61520-2606 | 2007-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497978480 | Walton Cs-xi P.C. | Chiropractor | 410 E. Elm Street, Canton, IL 61520 | 2007-04-10 |
| 1811912918 | Jennifer Christine Daniel-price | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2006-07-12 |
| 1245216241 | Fulton County Health Department | Clinic/Center | 700 East Oak Street, Canton, IL 61520 | 2005-12-21 |
| 1124482252 | Ryan Deushane | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520 | 2016-04-05 |
| 1750749826 | Shawn Michael Wynn | Nurse Anesthetist, Certified Registered | 210 W Walnut St, Canton, IL 61520 | 2016-02-04 |
| 1417312232 | Danielle Marianna Sausaman | Dietitian, Registered | 210 W Walnut St, Graham Hospital Food and Nutrition Services, Canton, IL 61520 | 2015-12-21 |
| 1740533835 | Abby L. Sherwood | Chiropractor | 410 E Elm Street, Canton, IL 61520 | 2012-10-26 |
| 1417261041 | Erin Kathleen Buckley | Obstetrics & Gynecology | 180 S Main St, Canton, IL 61520 | 2010-08-06 |
| 1619375532 | Brittany Nicole Miller | Nurse Practitioner | 1300 E Locust St, Canton, IL 61520-0008 | 2014-12-09 |
| 1437197845 | Heartland of Canton Il LLC | Clinic/Center | 2081 N Main St, Canton, IL 61520-1032 | 2006-06-04 |
| Find all providers in zip 61520 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568012011 | Weaver Counseling and Assessment Services, LLC | Psychologist | 4450 Belden Village St Nw Ste 604, Canton, OH 44718-3672 | 2019-09-17 |
| 1598134561 | Sharon Maxwell | Psychologist | 617 Chapman St, Canton, MA 02021-2065 | 2015-09-21 |
| 1174916688 | Harte Behavioral Health, LLC | Psychologist | 95 Washington St Ste 588, Canton, MA 02021-4003 | 2015-03-07 |
| 1942633839 | Caitlin Reid Roache | Psychologist | 500 Chapman St Unit 203, Canton, MA 02021-2040 | 2013-08-14 |
| 1962787796 | Meagan Elizabeth Johnson | Psychologist | 1202 Stacy Dr, Canton, MI 48188-1432 | 2011-10-12 |
| 1255611711 | Ryan Pecsenye | Psychologist | 7361 Windsor Woods Dr, 1c, Canton, MI 48187-2285 | 2011-08-27 |
| 1780829945 | Charles Orvis Hunter | Psychologist | 4450 Belden Village Ave Nw, Suite 205, Canton, OH 44718 | 2008-12-02 |
| 1669627444 | Laura Derr, Psyd, PC | Psychologist | 1017 Turnpike St, Suite 12c, Canton, MA 02021-2853 | 2008-11-20 |
| 1245407055 | David Herl | Psychologist | 2677 Cleveland Avenue Nw, Canton, OH 44709-3393 | 2008-05-12 |
| 1689865040 | Martin Steven Kurylowicz | Psychologist | 4005 Cornerstone Dr, Canton, MI 48188-7911 | 2007-08-09 |
| Find all providers in CANTON | ||||
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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.