MRS. AUDREY GONZALEZ (NPI# 1437610086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1437610086 |
Entity Type | Individual |
Full Name | MRS. AUDREY GONZALEZ |
Other Name | AUDREY WARTSBAUGH |
Credential | LCPC |
Practice Address |
1941 Frank Scott Pkwy E Ste C O Fallon IL 62269-7387 |
Practice Telephone | 6182068350 |
Enumeration Date | 2019-03-27 |
Last Update Date | 2019-06-11 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YP2500X |
Counselor Specialization: Professional |
180.012116 | IL | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | DEPARTMENT OF PROFESSIONAL REGULATION | 180.012116 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
3 Oak Dr Ste B, Maryville, IL 620625635 | 6189721568 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780035246 | Audrey Marie Gonzalez | Hearing Instrument Specialist | 3201 Airline Rd, Suite A, Corpus Christi, TX 78414-3570 | 2016-06-27 |
1659678696 | Audrey Parker Gonzalez | Counselor | 5305 N Scout Island Cir, Austin, TX 78731-6529 | 2011-02-25 |
1801398219 | Audrey Gonzalez | Physician Assistant | 3230 Interstate 30 Ste 100, Mesquite, TX 75150-2662 | 2018-03-01 |
1598867657 | Audrey Aracely Gonzalez | Nurse Practitioner | 947 S Anaheim Blvd, Suite 240, Anaheim, CA 92805-5582 | 2006-09-01 |
Street Address |
1941 FRANK SCOTT PKWY E STE C |
City | O FALLON |
State | IL |
Zip Code | 62269-7387 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326648155 | Kayla Revermann | Pharmacist | 1350 W Us Highway 50, Pharmacy, O Fallon, IL 62269 | 2020-10-30 |
1942814272 | Ashley Monique Gibson | Behavior Technician | Eagle Center, Ste 10, Ofallon, IL 62269 | 2020-09-03 |
1013533819 | Michelle Denise Voudrie | Registered Nurse | 321 Regency Park, O'fallon, IL 62269 | 2020-06-18 |
1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
1962063800 | Gerald Paskert | Pharmacist | 122 W. State St., O'fallon, IL 62269 | 2019-06-21 |
1780144808 | Bonnie Jean Lampe | Physical Therapy Assistant | 316 Donna Dr, O'fallon, IL 62269 | 2019-03-24 |
1134633993 | Latisha Smith | Psychologist | 600 S. Smiley St., O'fallon, IL 62269 | 2017-11-30 |
1619407210 | Brenna M Thomas | Registered Nurse | 1310 Engle Ct, O'fallon, IL 62269 | 2017-06-15 |
1881135622 | Pc Associates, LLC | Family Medicine | 800 East Highway 50, O'fallon, IL 62269 | 2017-03-13 |
1700230539 | Jennifer Farrell | Family Medicine | 3 St. Elizabeth's Blvd, Ste. 4000, O'fallon, IL 62269 | 2016-04-18 |
Find all providers in zip 62269 |
Taxonomy Code | 101YP2500X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Professional |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629683743 | Nicole Vandelinde | Counselor | 1805 Bowler Rd, O Fallon, IL 62269-7005 | 2020-09-15 |
1225641251 | Brenda French | Counselor | 302 Akoya Ct, O Fallon, MO 63366-4491 | 2020-08-28 |
1619590767 | Amanda Marie Dillard | Counselor | 981 Whitechapel Dr, O Fallon, IL 62269-7270 | 2020-05-23 |
1851922488 | Courtney Rydstrom | Counselor | 1001 Boardwalk Springs Pl Ste 113, O Fallon, MO 63368-4777 | 2020-02-02 |
1356716054 | Starrynite Counseling, LLC | Counselor | 8 Eagle Ctr Ste 4, O Fallon, IL 62269-1963 | 2015-12-07 |
1699149161 | Cristine Lou Mason | Counselor | 2940 Wheatfield Farms Dr, O Fallon, MO 63368-7848 | 2015-11-21 |
1205185774 | Amy Christine Ilgenfritz | Counselor | 311 S Main St Ste 100, O Fallon, MO 63366-2807 | 2012-08-30 |
1861769184 | Counseling Associates of Southern Illinois | Counselor | 1669 Windham Way Ste B, O Fallon, IL 62269-3072 | 2011-12-01 |
1952609729 | Sharon Lynn Bass | Counselor | 7116 Twin Chimneys Blvd, O Fallon, MO 63368-8166 | 2011-03-03 |
1013241405 | Lamette Johnstone | Counselor | 1137 N Main St Ste 2, O Fallon, MO 63366-1498 | 2009-10-01 |
Find all providers in O FALLON |
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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.