MICHELLE MARGARET PETTENGILL (NPI# 1639307077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639307077 |
| Entity Type | Individual |
| Full Name | MICHELLE MARGARET PETTENGILL |
| Credential | BA, CADC |
| Practice Address |
221 E State St Centerville IA 52544-1813 |
| Practice Telephone | 6418566471 |
| Practice Fax Number | 6418562779 |
| Mailing Telephone | 6418566471 |
| Mailing Fax Number | 6418562779 |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2009-06-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
09066 | IA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | CADC | 09066 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013038652 | Michelle Albanese Pettengill | Counselor | 3490 The Alameda, Santa Clara, CA 95050-4333 | 2007-04-02 |
| Street Address |
221 E STATE ST |
| City | CENTERVILLE |
| State | IA |
| Zip Code | 52544-1813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598748543 | Colleen Elizabeth Stephens | Social Worker | 221 E State St, Centerville, IA 52544-1813 | 2005-11-23 |
| 1033752423 | Chelsey Lynn Joiner | Counselor | 221 E State St, Centerville, IA 52544-1813 | 2019-10-18 |
| 1265094304 | Krista Lynn Johnson | Nurse Practitioner | 221 E State St, Centerville, IA 52544-1813 | 2019-06-28 |
| 1073091476 | Meredith Frasher | Social Worker | 221 E State St, Centerville, IA 52544-1813 | 2018-07-30 |
| 1649707977 | Brian Worth | Counselor | 221 E State St, Centerville, IA 52544-1813 | 2017-05-17 |
| 1962870196 | Regina M Lassabe | Counselor | 221 E State St, Centerville, IA 52544-1813 | 2015-09-03 |
| 1841544681 | Matthew J Dzak | Counselor | 221 E State St, Centerville, IA 52544-1813 | 2012-11-01 |
| 1457678203 | Danielle Lea O'brien | Counselor | 221 E State St, Centerville, IA 52544-1813 | 2010-05-03 |
| 1598975799 | Jeanne Frances Winslow | Counselor | 221 E State St, Centerville, IA 52544-1813 | 2007-05-23 |
| 1639387582 | Roshan Dasari | Psychiatry & Neurology | 221 E State St, Centerville, IA 52544-1813 | 2007-05-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053651166 | Amy Spencer | Pharmacist | 609 N. 18th Street, Centerville, IA 52544 | 2013-02-26 |
| 1710253497 | Caregivers Home Health, LLC | Home Health | 19999 Saint Josephs Drive, Centerville, IA 52544 | 2012-03-28 |
| 1558529206 | Mercy Medical Center-centerville | Clinic/Center | 19876 St. Joseph's Drive, Centerville, IA 52544 | 2008-05-29 |
| 1205023868 | Mercy Medical Center-centerville | Home Health | 1 St. Joseph's Drive, Centerville, IA 52544 | 2007-09-27 |
| 1043414394 | Appanoose Community Care Services | Home Health | 19890 St. Joseph's Drive, Centerville, IA 52544 | 2007-06-12 |
| 1659591816 | The Continental At St. Joseph's | Assisted Living Facility | 19999 St. Joseph's Drive, Centerville, IA 52544 | 2007-04-27 |
| 1255456315 | Kirk & Gordy Associates, LLC | Clinic/Center | 415 and A Half North Haynes, Centerville, IA 52544 | 2007-03-20 |
| 1114087574 | New Focus Inc | Clinic/Center | 102 W Washington, New Focus Inc, Centerville, IA 52544 | 2006-12-08 |
| 1134169030 | Ron Michael Harshman | Dentist | 501 W Jackson St, Centerville, IA 52544 | 2006-06-08 |
| 1700835865 | State University of Iowa | Family Medicine | 19876 St. Joseph Drive, Centerville, IA 52544 | 2006-05-08 |
| Find all providers in zip 52544 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384220 | Ron Lee Ward | Counselor | 950 E Alex Bell Rd Ste 100, Centerville, OH 45459-2721 | 2020-10-26 |
| 1548754146 | Jay Owen Wainscott | Counselor | 6239 Wilmington Pike, Centerville, OH 45459-7108 | 2018-06-18 |
| 1801251889 | Kelli Franklin | Counselor | 205 S Commerce St, Centerville, TX 75833-1965 | 2015-12-17 |
| 1629352117 | Victoria Schild Brown | Counselor | 25 S Main St Ste 208, Centerville, UT 84014-1840 | 2011-10-04 |
| 1033281084 | Cornerstone Counseling Center | Counselor | 526 N Main St, Centerville, IA 52544-1432 | 2006-11-14 |
| 1992315840 | Reins Recovery Center | Counselor | 601 Beech St, Centerville, TN 37033-1101 | 2020-08-05 |
| 1033752423 | Chelsey Lynn Joiner | Counselor | 221 E State St, Centerville, IA 52544-1813 | 2019-10-18 |
| 1275183733 | Dandelion Counseling | Counselor | 205 S Commerce St, Centerville, TX 75833-1965 | 2019-09-17 |
| 1457888141 | Cyntha Susanne See | Counselor | 111 North Main, Suite 2, Centerville, IA 52544 | 2017-05-12 |
| 1669859559 | Revention Psychiatry & Neurology, LLC | Counselor | 8002 Mcewen Rd, Centerville, OH 45458-2033 | 2015-04-30 |
| Find all providers in CENTERVILLE | ||||
| City | CENTERVILLE |
| Zip Code | 52544 |
Please comment or provide details below to improve the information on MICHELLE MARGARET PETTENGILL.
| 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.