DR. JAMES DOUGLAS PETTINELLI (NPI# 1538311865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538311865 |
| Entity Type | Individual |
| Full Name | DR. JAMES DOUGLAS PETTINELLI |
| Other Name | DR. JAMES DOUGLAS PETTINELLI |
| Practice Address |
4500 W Pine Blvd Saint Louis MO 63108-2186 |
| Practice Telephone | 3143615983 |
| Practice Fax Number | 3149772614 |
| Mailing Telephone | 3143615983 |
| Mailing Fax Number | 3149772614 |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2008-10-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TF0000X |
Psychologist Specialization: Family |
0905 | MO | Behavioral Health & Social Service Providers |
| Street Address |
4500 W PINE BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63108-2186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740494574 | Jeff D Piper | Social Worker | 4500 W Pine Blvd, Saint Louis, MO 63108-2186 | 2007-05-10 |
| 1942474598 | Edwin D. Wolfgram | Specialist | 4500 W Pine Blvd, Saint Louis, MO 63108-2186 | 2008-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851474 | Nigel Austen Thomas Cook | Social Worker | 4050 West Pine Blvd. Apt. 4118, St. Louis, MO 63108 | 2020-08-12 |
| 1467070011 | C2n Diagnostics, LLC | Clinical Medical Laboratory | 20 South Sarah Street, Saint Louis, MO 63108 | 2020-07-10 |
| 1609414358 | Kaylee Breitenbucher | Occupational Therapist | 4444 Forest Park Avenue, Msc 8505-94-01, St. Louis, MO 63108 | 2019-12-12 |
| 1114419546 | Activangels Home Health | Home Health | 4625 Lindell Blvd Ste 304, Saint Louis, MO 63108 | 2018-06-01 |
| 1215427349 | Heart To Heart Consolidated Home Care Service LLC | Home Health | 4625 Lindell Blvd Ste 200, Saint Louis, MO 63108 | 2018-05-15 |
| 1447755905 | Erin Virginia Adams | Student in an Organized Health Care Education/Training Program | 4355 Maryland Ave Apt 116, Saint Louis, MO 63108 | 2018-03-27 |
| 1033621172 | Roots Healthcare and Homes | In Home Supportive Care | 4300 Enright Ave, St. Louis, MO 63108 | 2017-10-30 |
| 1336661719 | House of Destiny Adult Day Care LLC | Clinic/Center | 4507 Olive Street, St Louis, MO 63108 | 2017-07-07 |
| 1003338492 | Khin Min Thu | Social Worker | 4236 Lindell Blvd., Suite 200, St Louis, MO 63108 | 2017-07-07 |
| 1679093967 | Together We Can Home Healthcare Services LLC | Home Health | 4144 Lindell Blvd Suite 221, Saint Louis, MO 63108 | 2017-06-27 |
| Find all providers in zip 63108 | ||||
| Taxonomy Code | 103TF0000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497275531 | Healing Hands Homecare and Sounseling Services LLC | Psychologist | 10439 Gardo Ct, Saint Louis, MO 63137-3507 | 2017-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023565348 | Integrative Family Psychology | Psychologist | 1340 E Meadowmere St, Springfield, MO 65804-0240 | 2016-09-02 |
| 1790919165 | Family Psychology of Springfield, LLC | Psychologist | 2053 S Waverly Ave, Springfield, MO 65804-2414 | 2009-05-13 |
| 1881934800 | Joseph Fredrick Hulgus Jr. | Psychologist | 2053 S Waverly Ave Ste D, Springfield, MO 65804-2497 | 2013-02-28 |
| City | SAINT LOUIS |
| Zip Code | 63108 |
Please comment or provide details below to improve the information on DR. JAMES DOUGLAS PETTINELLI.
| 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.