DR. ADAM MILES STURDEVANT (NPI# 1457585614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457585614 |
| Entity Type | Individual |
| Full Name | DR. ADAM MILES STURDEVANT |
| Credential | PSY.D. |
| Practice Address |
1049 Dousman St Green Bay WI 54303-3003 |
| Practice Telephone | 9208886868 |
| Mailing Telephone | 9208886868 |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2020-10-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
14358-130 | WI | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
3638-57 | WI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205349883 | Adam Sturdevant | Dentist | 610 Jones Ferry Rd Ste 206, Carrboro, NC 27510-6113 | 2017-11-06 |
| Street Address |
1049 DOUSMAN ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-3003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407979206 | William David Laakso | Psychologist | 700 N Adams St, Green Bay, WI 54301-5145 | 2007-04-08 |
| 1124154612 | Todd Lee Hamilton | Psychologist | 2339 Cedar Rdg, Green Bay, WI 54313-5700 | 2007-02-26 |
| 1114071289 | Bonnie Rae Nussbaum | Psychologist | 3600 Velp Ave Ste 4-a, Green Bay, WI 54313-6503 | 2007-01-23 |
| 1801954474 | Eric John Lund | Psychologist | 1575 Allouez Ave, Green Bay, WI 54311-5639 | 2006-12-05 |
| 1407920283 | Kevin Wayne Miller | Psychologist | 2131 S Webster Ave, Suite 105, Green Bay, WI 54301-2288 | 2006-11-20 |
| 1063513125 | Gerald Joseph Wellens | Psychologist | 130 E Walnut Street, Suite 603, Green Bay, WI 54301 | 2006-09-25 |
| 1326564949 | Michelle Schoenleber | Psychologist | 130 E Walnut St, Green Bay, WI 54301-4239 | 2017-08-15 |
| 1245688993 | Andrea Labine, Ph.d LLC | Psychologist | 1039 W Mason St, 116, Green Bay, WI 54303-1842 | 2016-06-02 |
| 1558799940 | Matthew Vendlinski | Psychologist | 2851 University Ave, Green Bay, WI 54311-5855 | 2013-10-22 |
| 1639501323 | Mandy J Kumpula | Psychologist | 2851 University Ave, Green Bay, WI 54311-5855 | 2013-08-05 |
| Find all providers in GREEN BAY | ||||
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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.