RICHARD LORNAL DODGE (NPI# 1639114663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639114663 |
| Entity Type | Individual |
| Full Name | RICHARD LORNAL DODGE |
| Other Name | DICK DODGE |
| Credential | PHD CADCII ICRE |
| Practice Address |
3407 Shamrock Ct Gautier MS 39553 |
| Mailing Address |
3407 Shamprock Ct Gautier MS 39553 |
| Practice Telephone | 2284970690 |
| Practice Fax Number | 2284971363 |
| Mailing Telephone | 2284970690 |
| Mailing Fax Number | 2284971363 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2008-04-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
A8424202 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00018214 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881017135 | Richard Dodge | Massage Therapist | 2418 E Bridge St, Brighton, CO 80601-2546 | 2014-01-22 |
| Street Address |
3407 SHAMROCK CT |
| City | GAUTIER |
| State | MS |
| Zip Code | 39553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184626905 | Julie T Trice | Nurse Practitioner | 3407 Shamrock Ct, Gautier, MS 39553 | 2005-08-11 |
| 1144820689 | Erica Lynn Holden | Case Manager/Care Coordinator | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2020-10-26 |
| 1588271100 | Kayla Mitchell | Case Manager/Care Coordinator | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2020-09-28 |
| 1134733967 | Elizabeth Ann Shepard-bynum | Peer Specialist | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2020-08-31 |
| 1336751916 | Courtney Dale Trull | Case Manager/Care Coordinator | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2020-08-17 |
| 1073138509 | Thomas Gregory Hicks | Case Manager/Care Coordinator | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2020-06-10 |
| 1588287148 | Kaitlyn Hinton | Case Manager/Care Coordinator | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2020-05-18 |
| 1043832140 | Brenda Gail Miller | Case Manager/Care Coordinator | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2020-05-12 |
| 1639716517 | Chiquita Walker | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2019-12-10 |
| 1629615505 | Alexusia Jones | Case Manager/Care Coordinator | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2019-12-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205465044 | Loggan Malone | Dentist | 2808 Us-90 W, Gautier, MS 39553 | 2020-04-03 |
| 1770979775 | Catherine Durham | Counselor | 3407 Shamrock Dr., Gautier, MS 39553 | 2015-04-07 |
| 1851648836 | Pharmatex, LLC | Pharmacy | 4551-d Gautier Vancleave Road, Gautier, MS 39553 | 2012-08-09 |
| 1891957544 | David W Bonderer Dds Pllc | Dentist | 2808 Hwy 90, Suite 1, Gautier, MS 39553 | 2008-06-25 |
| 1790830313 | William D Parrish | Dentist | 713 Us Hwy 90, Gautier, MS 39553 | 2007-01-24 |
| 1073685830 | Jeffrey Lamone Knight | Dentist | 3105 Shaw Dr., Gautier, MS 39553 | 2006-11-15 |
| 1720178437 | Erica B Wilson | Counselor | 3704 Shamrock Court, Gautier, MS 39553 | 2006-10-13 |
| 1881781631 | James D Victory | Chiropractor | 315 Highway 90, Gautier, MS 39553 | 2006-10-05 |
| 1508959180 | Robert Douglas Holbert | Internal Medicine | 2105 Old Spanish Trail, Gautier, MS 39553 | 2006-10-02 |
| 1962508119 | Sentry-gautier, Inc. | Nursing Facility/Intermediate Care Facility | 5090 Gautier Vancleave Road, Gautier, MS 39553 | 2006-09-15 |
| Find all providers in zip 39553 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023662822 | Debra Ann Dionne | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2019-07-30 |
| 1306315726 | Jacqueline Gail Pharr | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2018-11-14 |
| 1972055408 | Crystal Cox | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2016-11-01 |
| 1548647365 | Lori Howell | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2015-04-30 |
| 1902298227 | Sage M Moye | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2015-02-24 |
| 1356783237 | Sarah Marie Pradillo | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2013-07-22 |
| 1558704411 | Annie Williams | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2013-04-10 |
| 1194168302 | Robert L Smith | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2013-04-08 |
| 1629338579 | Amy H. Turner | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-6429 | 2012-05-25 |
| 1407135213 | Barbara Teresa Evans | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-6429 | 2011-08-10 |
| Find all providers in GAUTIER | ||||
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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.