JOHNSON NICHOLS HEALTH CLINIC, INC. (NPI# 1497305791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497305791 |
| Entity Type | Organization |
| Organization Name | JOHNSON NICHOLS HEALTH CLINIC, INC. |
| Practice Address |
645 S Rogers St Bloomington IN 47403-2353 |
| Practice Telephone | 7653771205 |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2019-09-18 |
| Authorized Official Name | ROBERT SIEGMANN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7653771205 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Centerstone Health Services, Inc. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114553948 | Johnson Nichols Health Clinic, Inc. | Clinic/Center | 720 N Marr Rd Ste A, Columbus, IN 47201-6660 | 2020-03-12 |
| 1518528579 | Johnson Nichols Health Clinic, Inc. | Clinic/Center | 390 Erie Ave Ste A, Connersville, IN 47331-3177 | 2019-06-21 |
| 1740305200 | Johnson Nichols Health Clinic, Inc. | Clinic/Center | 645 W Morgan St, Spencer, IN 47460-1133 | 2007-03-20 |
| Street Address |
645 S ROGERS ST |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47403-2353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831198316 | Scott A. Callaghan | Social Worker | 645 S Rogers St, Bloomington, IN 47403 | 2005-07-18 |
| 1659978591 | Shaleni Anne Watts | Nurse Practitioner | 645 S Rogers St, Bloomington, IN 47403-2353 | 2020-10-05 |
| 1356978365 | Sonila D Zajmi | Counselor | 645 S Rogers St, Bloomington, IN 47403-2353 | 2020-03-27 |
| 1750915831 | Lance Schattner | Case Manager/Care Coordinator | 645 S Rogers St, Bloomington, IN 47403-2353 | 2020-02-27 |
| 1720622442 | Joann Glen | Case Manager/Care Coordinator | 645 S Rogers St, Bloomington, IN 47403-2353 | 2019-11-06 |
| 1821649476 | Mary Harsin | Case Manager/Care Coordinator | 645 S Rogers St, Bloomington, IN 47403-2353 | 2019-09-25 |
| 1679122923 | Samuel Barbash-riley | Social Worker | 645 S Rogers St, Bloomington, IN 47403-2353 | 2019-09-10 |
| 1629530464 | Thomas D Phelps | Counselor | 645 S Rogers St, Bloomington, IN 47403-2353 | 2019-04-02 |
| 1104301175 | Holly Farabaugh | Case Manager/Care Coordinator | 645 S Rogers St, Bloomington, IN 47403-2353 | 2018-09-26 |
| 1669956926 | Mary Florence | Case Manager/Care Coordinator | 645 S Rogers St, Bloomington, IN 47403-2353 | 2018-09-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043783673 | Brook Whitaker | Registered Nurse | 4011 S. Monroe Medical Park Blvd, Bloomington, IN 47403 | 2019-01-07 |
| 1598251175 | Jacob Edward Lundorf | Nurse Practitioner | 2100 S Liberty Dr Ste B, Bloomington, IN 47403 | 2018-07-06 |
| 1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
| 1295276160 | Indiana Center for Recovery, LLC | Substance Abuse Rehabilitation Facility | 1004 W 1st Street, Bloomington, IN 47403 | 2017-03-13 |
| 1144694217 | Kayla Dewolf | Specialist/Technologist | 1471 W Allen St, Bloomington, IN 47403 | 2015-11-30 |
| 1164806444 | Monroe Hosoital | General Acute Care Hospital | 4011 Monroe Medical Park, Bloomington, IN 47403 | 2015-07-16 |
| 1821411588 | Jennifer Turner | Occupational Therapy Assistant | 1023 West Main St, Swiss Villa, Vevay, IN 47403 | 2014-01-30 |
| 1104170232 | Kendall Basore | Social Worker | 445 S. Landmark Ave., Bloomington, IN 47403 | 2012-10-26 |
| 1568715886 | Indiana Hearing LLC | Hearing Aid Equipment | 2019 S Liberty Dr, Bloomington, IN 47403 | 2012-10-24 |
| 1679870232 | Accurate Hearing Services | Clinic/Center | 1355 W Second St, #3, Bloomington, IN 47403 | 2011-02-17 |
| Find all providers in zip 47403 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023630357 | Janice Bush | Counselor | 909 W Olive St, Bloomington, IL 61701-4962 | 2020-05-08 |
| 1457986556 | Jon Brookson Engfer | Counselor | 8609 Lyndale Avenue South, Bloomington, MN 55420 | 2020-03-09 |
| 1346883501 | Christine Lee Garwick-foley | Counselor | 10032 Quebec Ave S, Bloomington, MN 55438-2126 | 2019-10-21 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1477990059 | Megan S Nickless | Counselor | 205 N College Ave Ste 613, Bloomington, IN 47404-3956 | 2013-05-23 |
| 1427329143 | Jared Brent Bostrom | Counselor | 1100 E 80th St, Bloomington, MN 55420-1426 | 2012-01-26 |
| 1437438181 | Walter Lawrence Campbell | Counselor | 600 N. Jordan Ave, Bloomington, IN 47405 | 2011-08-12 |
| 1720376221 | Jamie Laurson | Counselor | 702 W. Chestnut Street, Bloomington, IL 61701 | 2011-07-18 |
| 1396054037 | Carrie Ann Lawrence | Counselor | 6666 S Old State Road 37, Bloomington, IN 47401-8912 | 2010-09-29 |
| 1558691998 | Robarn Danzman | Counselor | 221 E Kirkwood Ave, Suite 5, Bloomington, IN 47408-3559 | 2010-01-07 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 47403 |
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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.