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).
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 |
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 |
Address | Telephone Number | Fax Number |
---|---|---|
1288 Suncrest Drive, Morgantown, WV 265082650 | 3049333884 |
Street Address |
527 MEDICAL PARK DR |
City | BRIDGEPORT |
State | WV |
Zip Code | 26330-9008 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 26330 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
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 |
Find all providers in BRIDGEPORT |
City | BRIDGEPORT |
Zip Code | 26330 |
Please comment or provide details below to improve the information on MS. SUSAN RENNAE KIRKENDALL.
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.