NICOLE DARLENE ETHRIDGE (NPI# 1760974596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760974596 |
| Entity Type | Individual |
| Full Name | NICOLE DARLENE ETHRIDGE |
| Credential | MA, PLPC |
| Practice Address |
33 E Jackson St Marshall MO 65340-2153 |
| Mailing Address |
1300 E Bradford Pkwy Springfield MO 65804-4264 |
| Practice Telephone | 6608868063 |
| Mailing Telephone | 4177615000 |
| Mailing Fax Number | 4177615065 |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2019-03-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 2018013675 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 490055189 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851746341 | Nicole Ethridge | Optometrist | 1076 Regency Ln, Carol Stream, IL 60188-4329 | 2016-05-03 |
| Street Address |
33 E JACKSON ST |
| City | MARSHALL |
| State | MO |
| Zip Code | 65340-2153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104871151 | Carol S Dickerson | Social Worker | 33 E Jackson St, Marshall, MO 65340-2153 | 2006-05-24 |
| 1013463348 | Kali Rae Hoffmann | Social Worker | 33 E Jackson St, Marshall, MO 65340 | 2016-08-28 |
| 1104243161 | Robin R Rasse-cott | Counselor | 33 E Jackson St, Marshall, MO 65340 | 2014-03-27 |
| 1669802021 | Laura Suzanne Baker | Counselor | 33 E Jackson St, Marshall, MO 65340-2153 | 2013-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791847 | Gerald D Robertson | Chiropractor | 1566 S Odell Ave, Marshall, MO 65340 | 2019-07-15 |
| 1659860765 | William L Pearman | Nurse Practitioner | Marshall Emergency Physicians, 2305 South Highway 65, Marshall, MO 65340 | 2018-05-03 |
| 1992204978 | Susan Elizabeth Lichtenberg | Speech-Language Pathologist | 860 W. Vest St., Marshall, MO 65340 | 2018-02-06 |
| 1568974616 | Falin Kay Larsen | Family Medicine | 2303 Us-65, Marshal, MO 65340 | 2017-10-30 |
| 1881132587 | Dana Zinn | Nurse Practitioner | 1547 Commerce Dr, Marshall, MO 65340 | 2017-02-02 |
| 1760877179 | Lifetime Dental Associates | Dentist | 2301 S. 65 Hwy, Suite 1, Marshall, MO 65340 | 2015-04-02 |
| 1780078949 | Glenda Cervantes | Interpreter | 1324 S Ellswort Ave, Marshall, MO 65340 | 2015-03-26 |
| 1174922173 | Michelle Stockman | Licensed Practical Nurse | 1004 S. Lincoln Ave, Marshall, MO 65340 | 2014-08-15 |
| 1730527722 | Lynn C Evans | Pharmacist | 941 S. Cherokee, Suite 1, Marshall, MO 65340 | 2013-06-12 |
| 1740589753 | Bethany Anne Harris | Social Worker | 1126 E. Hwy Ww, Marshall, MO 65340 | 2011-03-17 |
| Find all providers in zip 65340 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033573472 | Nicole Howe | Counselor | 315 S Liberty St, Marshall, MI 49068-1651 | 2016-04-12 |
| 1124254255 | Keshia Grinder | Counselor | 316 Hwy 65 N, Marshall, AR 72650 | 2009-06-03 |
| 1427101781 | Geraldine Young | Counselor | 410 W Grand, Marshall, TX 75670 | 2007-01-19 |
| 1306894290 | Gary D Morgan | Counselor | 316 Highway 65n, Marshall, AR 72650-1175 | 2006-05-04 |
| 1821696097 | Larissa Nichole Jones | Counselor | 505 E Travis St Ste 208, Marshall, TX 75670-4281 | 2020-10-11 |
| 1700236031 | Vonda Harness | Counselor | 316 Highway 65 N, Marshall, AR 72650-7863 | 2016-06-17 |
| 1548616618 | Scott Myers | Counselor | 1126 E Highway Ww, Marshall, MO 65340-4641 | 2016-05-09 |
| 1134521859 | Annissa Lewis | Counselor | 410 High St, Marshall, MI 49068-1224 | 2014-09-25 |
| 1366856072 | Kimberly Patterson | Counselor | 316 Highway 65 N, Marshall, AR 72650-7863 | 2014-06-20 |
| 1104243161 | Robin R Rasse-cott | Counselor | 33 E Jackson St, Marshall, MO 65340 | 2014-03-27 |
| Find all providers in MARSHALL | ||||
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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.