JEFFERY JON STUMBRAS (NPI# 1487676508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487676508 |
| Entity Type | Individual |
| Full Name | JEFFERY JON STUMBRAS |
| Credential | MSW |
| Practice Address |
2680 Vernon Dr Green Bay WI 54304-5374 |
| Practice Telephone | 9204964700 |
| Practice Fax Number | 9204964705 |
| Mailing Telephone | 9204964700 |
| Mailing Fax Number | 9204964705 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2012-01-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
2296 | WI | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 248 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39578400 | 05 |
| Street Address |
2680 VERNON DR |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54304-5374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003294729 | Joshua Lee Zimmer | Social Worker | 2680 Vernon Dr, Green Bay, WI 54304-5374 | 2015-05-14 |
| 1528445111 | Deborah Ann Goodine | Counselor | 2680 Vernon Dr, Green Bay, WI 54304-5374 | 2015-05-03 |
| 1689004830 | Breyan Donath-skeen | Social Worker | 2680 Vernon Dr, Green Bay, WI 54304-5374 | 2013-11-24 |
| 1508298100 | Kimberly Van Abel | Counselor | 2680 Vernon Dr, Green Bay, WI 54304-5374 | 2013-08-06 |
| 1164668653 | John Schatzman | Counselor | 2680 Vernon Dr, Green Bay, WI 54304-5374 | 2009-01-05 |
| 1356502561 | Jennifer E. Montgomery Fischer | Psychiatry & Neurology | 2680 Vernon Dr, Green Bay, WI 54304-5374 | 2008-06-19 |
| 1366603896 | Judith A. Feld | Social Worker | 2680 Vernon Dr, Green Bay, WI 54304-5374 | 2008-06-18 |
| 1487852406 | Kathryn M. Peterson | Counselor | 2680 Vernon Dr, Green Bay, WI 54304-5374 | 2007-07-11 |
| 1578761797 | Richa Aggarwal | Psychiatry & Neurology | 2680 Vernon Dr, Green Bay, WI 54304-5374 | 2007-07-10 |
| 1285752089 | Robert Vincent Gouthro Jr. | Psychiatry & Neurology | 2680 Vernon Dr, Green Bay, WI 54304-5374 | 2007-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689196255 | Kristen Ashley Haltom | Registered Nurse | 2979 Allied St Suite C, Green Bay, WI 54304 | 2017-07-14 |
| 1649671421 | Heather Marie Novak | Counselor | 2979 Allied St Unit C, Green Bay, WI 54304 | 2014-09-11 |
| 1356777684 | Nathan Weir | Specialist/Technologist | 1265 Lombardi Avenue, Green Bay, WI 54304 | 2013-09-18 |
| 1922349927 | John W Hartman | Internal Medicine | 916 Willard Dr, Suite 200, Green Bay, WI 54304 | 2013-03-15 |
| 1447551379 | Citralina M Haruo | Community Health Worker | 1110 11th Avenue, Green Bay, WI 54304 | 2010-11-09 |
| 1497061352 | Daniel James Gustin | Pharmacist | 1109 Lombardi Ave, Green Bay, WI 54304 | 2010-08-28 |
| 1316259898 | Karen A Detrick | Occupational Therapy Assistant | 1040 Pilgram Way, Woodside Senior Communities, Green Bay, WI 54304 | 2010-07-13 |
| 1861667362 | Planned Parenthood of Wi, Inc | Non-Pharmacy Dispensing Site | 2605 S. Oneida St. Suite 107, Green Bay, WI 54304 | 2008-04-25 |
| 1891967303 | Kimberley M Welk | Marriage & Family Therapist | 926 Willard Dr Ste 136, Green Bay, WI 54304 | 2008-03-25 |
| 1750563698 | Richard Lawrence Beyer | Hearing Instrument Specialist | 2154 S Ridge Rd, Green Bay, WI 54304 | 2007-12-03 |
| Find all providers in zip 54304 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1386154235 | Sara Dorow | Social Worker | 1499 Sixth Street, Green Bay, WI 54304-5430 | 2017-10-05 |
| 1790230589 | Lois Pulvermacher and Associates LLC | Social Worker | 840 Challenger Dr Ste 130, Green Bay, WI 54311-8351 | 2016-08-22 |
| 1194190264 | Ronald Harsh | Social Worker | 1596 Jay Ln, Green Bay, WI 54304-3427 | 2015-12-01 |
| 1851622005 | Michael Andrew Larkey | Social Worker | 815 Reber St, Green Bay, WI 54302-1116 | 2010-01-27 |
| 1861665002 | Leslie A Heckman | Social Worker | 111 S Jefferson Street, Green Bay, WI 54301 | 2008-04-09 |
| 1215078662 | Lois A Pulvermacher | Social Worker | 840 Challenger Dr, Ste 130, Green Bay, WI 54311-8351 | 2007-02-09 |
| 1467599431 | Kathleen J Bahler | Social Worker | 603 Beaupre St, Green Bay, WI 54301-2412 | 2007-01-31 |
| 1437204138 | Lisa Ann Burke | Social Worker | 2339 Cedar Ridge Court, Green Bay, WI 54303 | 2007-01-24 |
| 1831243328 | Barbara D Meyer | Social Worker | 2339 Cedar Ridge, Innovative Counseling Inc, Green Bay, WI 54313 | 2007-01-22 |
| 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.