MS. MARISA JON PHILLIPS (NPI# 1588751168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588751168 |
| Entity Type | Individual |
| Full Name | MS. MARISA JON PHILLIPS |
| Credential | LPC/NCC |
| Practice Address |
3402 Daniel Mccall Dr Ste 21 Lufkin TX 75904-7191 |
| Mailing Address |
1405 Ashley Ave Lufkin TX 75904-3659 |
| Practice Telephone | 9366373300 |
| Practice Fax Number | 9366371614 |
| Mailing Telephone | 9366373300 |
| Mailing Fax Number | 9366371614 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
14106 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1426504 | 05 | |
| TX | BLUE CROSS/BLUE SHIELD | 83663L | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871764357 | Marisa M Phillips | Registered Nurse | 313 Larkin St, Eagle, WI 53119-2233 | 2008-03-12 |
| 1528554045 | Marisa Phillips | Physician Assistant | 40 George Karl Blvd, Williamsville, NY 14221-7183 | 2018-07-09 |
| 1962771154 | Marisa Phillips | Occupational Therapist | 411 N Washington Ave, Suite 4000, Dallas, TX 75246-1713 | 2011-12-19 |
| 1770712648 | Marisa K Phillips | Nurse Practitioner | 3676 Parker Blvd, Pueblo, CO 81008-2212 | 2009-07-13 |
| Street Address |
3402 DANIEL MCCALL DR STE 21 |
| City | LUFKIN |
| State | TX |
| Zip Code | 75904-7191 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215070362 | Buckner Children & Family Services of Deep East Texas | Social Worker | 3402 Daniel Mccall Dr Ste 21, Lufkin, TX 75904-7191 | 2007-02-15 |
| 1699856435 | Brenda Russell Dunn | Social Worker | 3402 Daniel Mccall Dr Ste 21, Lufkin, TX 75904-7191 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437759750 | David Kent Emmerling | Pharmacist | Walmart Pharmacy 10-0140, 2500 Daniel Mccall Drive, Lufkin, TX 75904 | 2020-10-27 |
| 1831732718 | Isaac Kwame Agyare | Pharmacist | 1522 West Frank Ave. Room 127, Lufkin, TX 75904 | 2019-10-23 |
| 1598314999 | Eva Faye Mcduffie | Technician | 1006 Sherwood Rd., Lufkin, TX 75904 | 2019-09-09 |
| 1477036119 | Tyra Williams | Occupational Therapy Assistant | 902 Hill Street, Lufkin, TX 75904 | 2018-09-10 |
| 1720560188 | Veronica Monique Kennedy | Pharmacist | 1522 West Frank, Lufkin, TX 75904 | 2018-09-02 |
| 1356821532 | Mark Anthony Plowman | Licensed Vocational Nurse | 379 Copperfield Loop, Lufkin, TX 75904 | 2018-08-17 |
| 1396222311 | Kevin Pulikottil Cherian | Occupational Therapist | 402 S John Redditt Dr., Lufkin, TX 75904 | 2018-07-23 |
| 1922593029 | Sarah Marie Stuart | Dentist | 103 N Brentwood Dr, Unit 400, Lufkin, TX 75904 | 2018-06-30 |
| 1083104004 | Pam Specialty Hospital of Lufkin, LLC | Long Term Care Hospital | 1201 W Frank Ave Ste D5, Lufkin, TX 75904 | 2018-05-15 |
| 1124523840 | Jane C Davidson | Nurse Practitioner | 1 Medical Center Blvd Ste C, Lufkin, TX 75904 | 2018-03-26 |
| Find all providers in zip 75904 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295226520 | Julieta Banda Edmond | Counselor | 103 Wildlife Ln, Lufkin, TX 75904-1615 | 2018-05-22 |
| 1962947549 | Marsha Bradford | Counselor | 805 Sandyland Dr, Lufkin, TX 75904-5700 | 2017-01-05 |
| 1326422197 | Julie Marie Mcmanus | Counselor | 888 Carrell Rd, Lufkin, TX 75901-4770 | 2015-07-11 |
| 1588005870 | Kyle J Hanes | Counselor | 814 Ellis Ave, Lufkin, TX 75904-3812 | 2013-07-15 |
| 1790020246 | Brandy A Goins-whitehead | Counselor | 103 Wildlife Lane, Lufkin, TX 75904 | 2012-12-10 |
| 1093009441 | Jana Lee Richardson | Counselor | 1098 Benton Dr, Lufkin, TX 75901-7907 | 2011-06-02 |
| 1710284146 | Ranleigh Jayne Mcadams | Counselor | 1332 E Denman Ave, Ste 103, Lufkin, TX 75901-5764 | 2011-02-21 |
| 1033412309 | Emily Kathleen Havard | Counselor | 600 South John Redditt Drive, Lufkin, TX 75904-3121 | 2010-12-08 |
| 1346419538 | Charlotte Ann Ingle | Counselor | 512 Kiln St, Lufkin, TX 75904-3855 | 2008-02-21 |
| 1851506141 | Christi Leigh Rowe | Counselor | 207 E Frank Ave, Lufkin, TX 75901-0301 | 2007-05-11 |
| Find all providers in LUFKIN | ||||
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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.