MADELINE KETTLEWELL (NPI# 1538692512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538692512 |
| Entity Type | Individual |
| Full Name | MADELINE KETTLEWELL |
| Practice Address |
1601 W Balboa Blvd Newport Beach CA 92663-4527 |
| Mailing Address |
3419 Via Lido 310 Newport Beach CA 92663-3908 |
| Practice Telephone | 9497232388 |
| Practice Fax Number | 9497231288 |
| Mailing Telephone | 9497232388 |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2017-04-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
1601 W BALBOA BLVD |
| City | NEWPORT BEACH |
| State | CA |
| Zip Code | 92663-4527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558657809 | Ocean Recovery, LLC | Substance Abuse Rehabilitation Facility | 1601 W Balboa Blvd, Newport Beach, CA 92663-4527 | 2011-06-24 |
| 1548899032 | Allyssa Vanhooser | Marriage & Family Therapist | 1601 W Balboa Blvd, Newport Beach, CA 92663-4527 | 2020-04-06 |
| 1306379250 | Anna Werner | Counselor | 1601 W Balboa Blvd, Apt D, Newport Beach, CA 92663-4527 | 2017-04-07 |
| 1205367737 | Melissa Grace Jackson | Counselor | 1601 W Balboa Blvd, Apt D, Newport Beach, CA 92663-4527 | 2017-03-26 |
| 1699206342 | Kristine Angerer | Behavior Technician | 1601 W Balboa Blvd, Newport Beach, CA 92663-4527 | 2017-03-24 |
| 1215468921 | Michelle Catherine Boudreaux | Counselor | 1601 W Balboa Blvd, Newport Beach, CA 92663-4527 | 2017-03-23 |
| 1275064966 | Brittany Barger | Counselor | 1601 W Balboa Blvd, Newport Beach, CA 92663-4527 | 2017-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851905483 | Oasis Anesthesia, Surgical and Medical Group, Inc | Anesthesiology | 496 Old Newpor Blvd., Suite 2, Newport Beach, CA 92663 | 2020-09-01 |
| 1699232801 | Megan Gregor | Surgery | One Hoag Dr., Bldg 41, Ste 122, Newport Beach, CA 92663 | 2019-02-24 |
| 1831621382 | Narges Maududi | Social Worker | 1965 Sherrington Place, K111, Newport Beach, CA 92663 | 2017-04-03 |
| 1225495153 | Mitchelle Giorgi | Physical Therapist | 351 Hospital Road, Suite 007, Newport Beach, CA 92663 | 2016-01-22 |
| 1043620057 | Leslie Mccormack | Speech-Language Pathologist | 270 Cagney Lane #101, Newport Beach, CA 92663 | 2014-04-29 |
| 1265867162 | Hotel California By The Sea, LLC | Substance Abuse Rehabilitation Facility | 4504 Seashore Drive, Newport Beach, CA 92663 | 2013-09-10 |
| 1538504733 | Shawn Zardouz | Psychiatry & Neurology | 3900 W Coast Hwy Ste 390, Newport Beach, CA 92663 | 2013-05-02 |
| 1326330119 | Denise Fortenberry Fortenberry-gratias | Nurse Practitioner | 520 Superior Ave, Suite 350, Newport Beach, CA 92663 | 2011-05-11 |
| 1043500390 | Romit Kumar Kar | Pediatrics | 355 Placentia Ave Ste 301, Newport Beach, CA 92663 | 2011-04-07 |
| 1477858546 | Newport Neurohospitalists | Neurological Surgery | 510 Superior Ave Ste 280, Newport Beach, CA 92663 | 2011-01-20 |
| Find all providers in zip 92663 | ||||
| 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 |
|---|---|---|---|---|
| 1396202669 | Carlos Aytch-redmond | Counselor | 1544 Placentia Ave Apt 19, Newport Beach, CA 92663-2859 | 2019-02-22 |
| 1356843494 | Shahrzad Jamshid Dehmobad Nasrabadi | Counselor | 881 Dover Dr Ste 380, Newport Beach, CA 92663-6932 | 2018-03-05 |
| 1407227143 | Amanda Ross | Counselor | 4230 Park Newport Apt 202, Newport Beach, CA 92660-6068 | 2015-10-07 |
| 1821493875 | To Pham | Counselor | 16 Via Coralle, Newport Beach, CA 92657-1625 | 2014-10-31 |
| 1134474158 | Diana V Duran | Counselor | 4701 Von Karman Ave Ste 323, Newport Beach, CA 92660 | 2012-07-16 |
| 1760776611 | Tonya Thomas | Counselor | 6 Seaside Cir, Newport Beach, CA 92663-2734 | 2011-06-07 |
| 1043503766 | Christianne Cook D'ambrosio | Counselor | 26 Ocean Vis, Newport Beach, CA 92660-6224 | 2011-05-27 |
| 1639365018 | Michelle Renee Palmer | Counselor | 1000 Quail St Ste 185, Newport Beach, CA 92660 | 2007-09-19 |
| 1306379250 | Anna Werner | Counselor | 1601 W Balboa Blvd, Apt D, Newport Beach, CA 92663-4527 | 2017-04-07 |
| 1205367737 | Melissa Grace Jackson | Counselor | 1601 W Balboa Blvd, Apt D, Newport Beach, CA 92663-4527 | 2017-03-26 |
| Find all providers in NEWPORT BEACH | ||||
| City | NEWPORT BEACH |
| Zip Code | 92663 |
Please comment or provide details below to improve the information on MADELINE KETTLEWELL.
| 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.