JACKIE MARIE WOOD (NPI# 1790274959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790274959 |
| Entity Type | Individual |
| Full Name | JACKIE MARIE WOOD |
| Credential | LPCC |
| Practice Address |
710 S 2nd St Mankato MN 56001-3810 |
| Practice Telephone | 5076257660 |
| Practice Fax Number | 5076258998 |
| Mailing Telephone | 5076257660 |
| Mailing Fax Number | 5076258998 |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2020-04-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
CC01773 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | LICENSED PROFESSIONAL CLINICAL COUNSELOR | CC01773 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 226 N Broad St, Mankato, MN 560013520 | 5079318040 | 5079318060 |
| 401 3rd Ave Ne, Waseca, MN 560933301 | 5076257660 | 5076258998 |
| 760 Elmwood Ave S, Le Sueur, MN 560582169 | 5079318040 | 5079318060 |
| Street Address |
710 S 2ND ST |
| City | MANKATO |
| State | MN |
| Zip Code | 56001-3810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780779744 | Barbara Jean Kuhlman | Psychologist | 710 S 2nd St, Mankato, MN 56001-3810 | 2006-10-04 |
| 1225679343 | Kayle N Erickson | Social Worker | 710 S 2nd St, Mankato, MN 56001-3810 | 2019-09-30 |
| 1487770319 | Carole A Staelgraeve | Counselor | 710 S 2nd St, Mankato, MN 56001-3810 | 2007-03-22 |
| 1356473193 | Diane Caspers | Psychologist | 710 S 2nd St, Mankato, MN 56001-3810 | 2007-03-09 |
| 1861534067 | Lynn Sheldon Oliver | Counselor | 710 S 2nd St, Mankato, MN 56001-3810 | 2007-02-13 |
| 1437244118 | Beverly Jean Mueller | Social Worker | 710 S 2nd St, Mankato, MN 56001-3810 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1619448941 | Jessica Leigh Harder | Counselor | 226 N Broad St, Mankato, MN 56001-3520 | 2018-12-16 |
| 1538680301 | Laura S Riness | Counselor | 421 E Hickory St Ste 402, Mankato, MN 56001-2637 | 2017-07-03 |
| 1235526542 | Christine Frances | Counselor | 138 Oak Knoll Blvd, Mankato, MN 56001-2612 | 2015-04-24 |
| 1912317090 | Thad Matthew Shunkwiler | Counselor | 1400 Madison Ave; Suite 610, Adult, Child & Family Services, LLC, Mankato, MN 56001 | 2014-04-29 |
| 1679840912 | Anita Linnea Smith | Counselor | 515 N Riverfront Dr, Suite 220, Mankato, MN 56001-3471 | 2011-11-30 |
| 1750599577 | Lisa Joanne Rinehart | Counselor | 127 Red Oak Ln, Mankato, MN 56001-8997 | 2007-05-18 |
| 1184239055 | Alexis D Gleason | Counselor | 44 Good Counsel Dr, Mankato, MN 56001-6599 | 2020-09-09 |
| 1902410467 | Edward A Frey | Counselor | 44 Good Counsel Dr, Mankato, MN 56001-6599 | 2020-09-02 |
| 1851927107 | Andrea Herber | Counselor | 44 Good Counsel Dr, Mankato, MN 56001-6599 | 2020-03-19 |
| Find all providers in MANKATO | ||||
Please comment or provide details below to improve the information on JACKIE MARIE WOOD.
| 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.