MR. GEORGE E MOREDOCK III (NPI# 1639675184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639675184 |
| Entity Type | Individual |
| Full Name | MR. GEORGE E MOREDOCK III |
| Credential | LPN |
| Practice Address |
2848 N Taylor Ln Casa Grande AZ 85122-5870 |
| Practice Telephone | 5202136722 |
| Mailing Telephone | 5202136722 |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2018-04-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | LPC16741 | AZ | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LPC167741 | AZ | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LPC16741 | AZ | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
LPC16741 | AZ | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | LPC16741 | AZ | Behavioral Health & Social Service Providers |
| Street Address |
2848 N TAYLOR LN |
| City | CASA GRANDE |
| State | AZ |
| Zip Code | 85122-5870 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043857097 | Karen M Garcia | Registered Nurse | 2631 N Brown Avenue, Casa Grande, AZ 85122 | 2019-12-09 |
| 1063060291 | Martha Bollin | Registered Nurse | 2631 N. Brown Ave., Casa Grande, AZ 85122 | 2019-08-30 |
| 1841846920 | Banner Imaging Services LLC | Radiology | 1828 E. Florence Blvd Bldg B Ste 118 & 128, Suite 118 and 128, Casa Grande, AZ 85122 | 2019-08-14 |
| 1629532692 | Kirk Lee Mackley | Physical Therapist | Vibrant Care, 1355 E Florence Blvd #137, Casa Grande, AZ 85122 | 2019-01-24 |
| 1205307436 | Natalie T Trujillo | Physician Assistant | 301 E Cottonwood Ln Ste 1&2, Casa Grande, AZ 85122 | 2018-12-16 |
| 1710455860 | Community Intervention Associates, Inc | Clinic/Center | 1667 N. Trekell Rd, Suite 101 & 102, Casa Grande, AZ 85122 | 2018-11-07 |
| 1245728302 | Jenkins Chiropractic LLC | Chiropractor | 1891 N Trekell Rd Ste 2, Casa Grande, AZ 85122 | 2018-04-24 |
| 1497242408 | Kelly Winnett | Naturopath | 1415 N Trekell Rd Ste 102, Casa Grande, AZ 85122 | 2018-04-16 |
| 1851895783 | Michael Brubaker Counseling | Community/Behavioral Health | 1927 N. Trekell Rd, Ste D, Casa Grande, AZ 85122 | 2018-03-23 |
| 1770095317 | Walmart Stores Inc. | Pharmacy | 1741 E. Florence Blvd, Casa Grande, AZ 85122 | 2017-11-03 |
| Find all providers in zip 85122 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013543750 | Jacquette Shineese Brown | Counselor | 1901 N Trekell Rd Ste A, Casa Grande, AZ 85122-1770 | 2020-03-13 |
| 1609432731 | Crossroads Church | Counselor | 3151 N Piper Ave, Casa Grande, AZ 85122-3725 | 2019-05-14 |
| 1972097111 | Uvoltta Francis | Counselor | 1274 W Beacon Ct, Casa Grande, AZ 85122-6667 | 2018-06-20 |
| 1982954335 | Denice Carr | Counselor | 1901 N. Trekell Rd, Casa Grande, AZ 85122 | 2012-09-13 |
| 1477043792 | Leticia Federico Martinez | Counselor | 900 E Florence Blvd Ste G, Casa Grande, AZ 85122-4673 | 2018-05-11 |
| 1437694114 | Clara Williams | Counselor | 210 E Cottonwood Ln, Casa Grande, AZ 85122-2514 | 2017-01-04 |
| 1740679729 | Brenda Martin | Counselor | 900 E Florence Blvd, Casa Grande, AZ 85122-4666 | 2015-01-14 |
| 1811392368 | Rebecca Molden | Counselor | 865 N Arizola Rd, Casa Grande, AZ 85122-6011 | 2014-10-27 |
| 1184064982 | Nazcare, Inc. - Desert Rose Wellness Center | Counselor | 901 E Cottonwood Ln, Casa Grande, AZ 85122-2221 | 2013-06-26 |
| 1497005656 | Jose B. Cornejo | Counselor | 1901 N Trekell Rd, Casa Grande, AZ 85122-1770 | 2012-09-14 |
| Find all providers in CASA GRANDE | ||||
| City | CASA GRANDE |
| Zip Code | 85122 |
Please comment or provide details below to improve the information on MR. GEORGE E MOREDOCK III.
| 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.