MS. SUSAN RENNAE KIRKENDALL


Address: 527 Medical Park Dr, Bridgeport, WV 26330-9008
Phone: 3049333884

MS. SUSAN RENNAE KIRKENDALL (NPI# 1760967400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760967400
Entity Type Individual
Full Name MS. SUSAN RENNAE KIRKENDALL
Credential MS,AADC
Practice Address 527 Medical Park Dr
Bridgeport
WV 26330-9008
Mailing Address 1100 Andrew Dr
Morgantown
WV 26508-6842
Practice Telephone 3049333884
Mailing Telephone 3042906533
Enumeration Date 2018-09-28
Last Update Date 2018-09-28
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
98-302 WV Behavioral Health & Social Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
1288 Suncrest Drive, Morgantown, WV 265082650 3049333884

Office Location

Street Address 527 MEDICAL PARK DR
City BRIDGEPORT
State WV
Zip Code 26330-9008

Providers in the same location

NPI Name Taxonomy Address Enumeration
1134101660 United Hospital Center Inc Family Medicine 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9010 2005-11-18
1457886988 Rachel S Holeman Student in an Organized Health Care Education/Training Program 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 2017-04-21
1205360237 Nathan E Russell Student in an Organized Health Care Education/Training Program 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 2017-04-17
1255865275 Brandon M Lewko Emergency Medicine 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 2017-04-17
1144754177 Premkumar Chandrakantbhai Patel General Practice 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 2017-04-17
1922546175 Leslie D. Mavromatis Counselor 527 Medical Park Dr, Bridgeport, WV 26330-9008 2017-02-08
1316491996 Ellen Palmer Hoban Nurse Practitioner 527 Medical Park Dr, Suite 105, Bridgeport, WV 26330-9008 2016-08-11
1194170571 Matthan Jackson Family Medicine 527 Medical Park Dr, Ste 500, Bridgeport, WV 26330-9008 2016-05-04
1447605837 Arsalan Khawaja Student in an Organized Health Care Education/Training Program 527 Medical Park Dr, Ste 500, Bridgeport, WV 26330-9008 2016-05-04
1902251374 Kristin Black Student in an Organized Health Care Education/Training Program 527 Medical Park Dr, Ste 500, Bridgeport, WV 26330-9008 2016-05-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1992303036 Gage Mackenzie Chichester Nurse Anesthetist, Certified Registered 2673 Medical Park Drive, Bridgeport, WV 26330 2020-10-12
1851914105 Melany Langhurst Social Worker 64 Professional Place, Suite 102, Bridgeport, WV 26330 2020-05-21
1245704980 Adam Christopher Stonestreet Social Worker Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 2019-01-16
1588146658 Bridgeport Physical Therapy Services, Inc. Occupational Therapist 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 2018-09-05
1275040685 White Oaks Assisted Living Assisted Living Facility 140 Professional Place White Oaks, Bridgeport, WV 26330 2018-01-08
1275049371 Regional Eye Associates, Inc Ophthalmology 220 Southview Drive, Bridgeport, WV 26330 2017-12-27
1528586187 Savanna Tamia Brown Social Worker 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 2017-09-05
1184079642 Karla Kay Rinehart Social Worker 27 Trovato St., Suite 103, Bridgeport, WV 26330 2016-05-03
1396176756 Willo Group LLC Pharmacy 460 E. Main Street, Bridgeport, WV 26330 2013-12-10
1891031878 Sherri Michelle Dobson Occupational Therapy Assistant 1000 Maplewood Dr, Bridgeport, WV 26330 2012-12-20
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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1952912271 Patience Ashong Counselor 191 High Ridge Dr, Bridgeport, CT 06606-4965 2020-08-11
1871133371 Pamela Mcmahon Counselor 3851 Main St Fl 2, Bridgeport, CT 06606-2864 2020-01-13
1922580737 Jacqueline Renee Scott Counselor 566 Wilmot Ave Unit 1, Bridgeport, CT 06607-1107 2018-08-29
1225556418 Louis L Reed Counselor 3334 Main St, Bridgeport, CT 06606-4227 2017-09-07
1609396951 Eleanora Morgan Counselor 336 Midland St, Bridgeport, CT 06605-3546 2017-06-27
1316487630 Louis L. Reed Counselor 189 Smith St, Bridgeport, CT 06607-2220 2017-03-06
1003288168 Jacqueline Rodriguez Counselor 243 Success Ave, Bridgeport, CT 06610-2429 2015-10-28
1487024238 Onorio Dadamo Counselor 350 Fairfield Ave, Bridgeport, CT 06604-6014 2015-10-05
1588985584 Fritz Maignan Counselor 48 Alpine St, Bridgeport, CT 06610-1727 2010-06-14
1942453287 Darrin Allan Mcallister Counselor 289 Laurel Ave, Bridgeport, CT 06605-1102 2008-10-30
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Competitor

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City BRIDGEPORT
Zip Code 26330

Improve Information

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Dataset Information

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.

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