VICKIE LYNN KITTLE (NPI# 1578100244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578100244 |
| Entity Type | Individual |
| Full Name | VICKIE LYNN KITTLE |
| Practice Address |
1200 N West Ave Jackson MI 49202-2179 |
| Practice Telephone | 5177891200 |
| Enumeration Date | 2019-12-02 |
| Last Update Date | 2019-12-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 175T00000X | Peer Specialist | Other Service Providers | ||
| N | 175T00000X | Peer Specialist | MA | Other Service Providers | |
| Y | 175T00000X | Peer Specialist | MI | Other Service Providers |
| Street Address |
1200 N WEST AVE |
| City | JACKSON |
| State | MI |
| Zip Code | 49202-2179 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366496051 | Dennis J Glandon | Social Worker | 1200 N West Ave, Suite 400, Jackson, MI 49202-2179 | 2006-05-19 |
| 1669084810 | Sarah Lynn Ackerman | Case Manager/Care Coordinator | 1200 N West Ave, Jackson, MI 49202-2179 | 2020-08-19 |
| 1265055925 | Kelly Ann Parten | Case Manager/Care Coordinator | 1200 N West Ave, Jackson, MI 49202-2179 | 2020-05-28 |
| 1568084143 | James L Horrigan II | Social Worker | 1200 N West Ave, Jackson, MI 49202-2179 | 2020-05-18 |
| 1821619099 | Kimberly Kay Bomar | Social Worker | 1200 N West Ave, Jackson, MI 49202-2179 | 2020-04-29 |
| 1255951281 | Stephanie Elizabeth Goodrich | Case Manager/Care Coordinator | 1200 N West Ave, Jackson, MI 49202-2179 | 2020-04-20 |
| 1104463306 | Chad Lige | Health Educator | 1200 N West Ave, Jackson, MI 49202-2179 | 2019-12-06 |
| 1710522701 | Crystal Ann Chaffee | Social Worker | 1200 N West Ave, Jackson, MI 49202-2179 | 2019-11-13 |
| 1184269169 | Stephanie Leeann Justice | Case Manager/Care Coordinator | 1200 N West Ave, Jackson, MI 49202-2179 | 2019-11-13 |
| 1366086969 | Marguerite Mavourneen Taylor | Social Worker | 1200 N West Ave, Jackson, MI 49202-2179 | 2019-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821590316 | Leslie Dominique Barroso | Social Worker | 834 Kennedy St, Jackson, MI 49202 | 2018-03-01 |
| 1073011136 | Nicole Szarek | Social Worker | 1200 N. West Ave, Jackson, MI 49202 | 2018-01-24 |
| 1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
| 1285081612 | Patricia Decker | Psychologist | 950 West Monroe, Suite 500, Jackson, MI 49202 | 2016-05-16 |
| 1619344314 | Erica Ries | Social Worker | 1200 N West Ave Ste 800, Jackson, MI 49202 | 2015-08-28 |
| 1184007189 | Sarah Johnson | Behavioral Analyst | 818 Winifred St, Jackson, MI 49202 | 2015-07-08 |
| 1871971697 | Scott A Watterson Dds, Pllc | Dentist | 1030 Laurence Ave, Suite 3, Jackson, MI 49202 | 2015-05-13 |
| 1043608680 | Brenda Beverly | Counselor | 1190 West, 1190 West Suite 812, Jackson, MI 49202 | 2015-01-06 |
| 1295091593 | Natalie Ann Kember | Social Worker | 1206 Clinton, Jackson, MI 49202 | 2012-04-11 |
| 1912218728 | Tina Marie Pierce | Respite Care | 225 N Wisner St, Jakson, MI 49202 | 2010-06-25 |
| Find all providers in zip 49202 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144836271 | Wood M Palmer | Peer Specialist | 610 W Broadway Ave Ste L1, Jackson, WY 83001-8213 | 2020-09-23 |
| 1588229355 | Christine Ann Kint | Peer Specialist | 1200 N West Ave, Jackson, MI 49202-2179 | 2019-05-07 |
| 1285298638 | Douglas Laverne Brinker | Peer Specialist | 1200 N West Ave, Jackson, MI 49202-2179 | 2019-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026284 | Leah Mae Sindone | Peer Specialist | 22324 Derby Rd, Woodhaven, MI 48183-3700 | 2020-09-04 |
| 1992314728 | Willie Earl Feggins | Peer Specialist | 370 Country Club Rd, Holland, MI 49423-8303 | 2020-07-28 |
| 1831711613 | John Lee Williams Jr. | Peer Specialist | 24400 Schoolcraft, Redford, MI 48239-2633 | 2020-05-14 |
| 1568084861 | Zannie Roy Jackson Jr. | Peer Specialist | 36801 Ann Arbor Trl, Livonia, MI 48150-3422 | 2020-05-11 |
| 1417578865 | Veronica R Vasquez | Peer Specialist | 500 Hancock St # 48602, Saginaw, MI 48602-4224 | 2020-04-27 |
| 1235768680 | Matthew Milz | Peer Specialist | 145o S Lapeer Rd, Oxford, MI 48371-4982 | 2020-04-07 |
| 1558996132 | Camille Jewell Jackson | Peer Specialist | 8181 N Wayne Rd Apt S2147, Westland, MI 48185-3842 | 2020-03-04 |
| 1073146908 | James Laroach | Peer Specialist | 913 W. Homes Suite 200, Lansing, MI 48910 | 2020-02-19 |
| 1578193827 | Axel Lee Gruenberg | Peer Specialist | 221790 West 9 Mile, Southfield, MI 48033 | 2020-01-24 |
| 1962032078 | Brianne Salchert | Peer Specialist | 1170 Michigan Rd., Port Huron, MI 48060 | 2020-01-17 |
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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.