MACKENZIE R PHERIGO (NPI# 1801002142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801002142 |
| Entity Type | Individual |
| Full Name | MACKENZIE R PHERIGO |
| Credential | LCSW, CADC |
| Practice Address |
2148 Vadalabene Dr Maryville IL 62062-5632 |
| Practice Telephone | 6182883100 |
| Practice Fax Number | 6182883371 |
| Mailing Telephone | 6182883100 |
| Mailing Fax Number | 6182883371 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2008-06-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | 150.009882 | IL | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
149.013008 | IL | Behavioral Health & Social Service Providers |
| Street Address |
2148 VADALABENE DR |
| City | MARYVILLE |
| State | IL |
| Zip Code | 62062-5632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699316877 | Terry Glenn | Counselor | 2148 Vadalabene Dr, Maryville, IL 62062-5632 | 2019-09-30 |
| 1144750605 | Rebecca Leigh Salah | Counselor | 2148 Vadalabene Dr, Maryville, IL 62062-5632 | 2017-06-18 |
| 1649726340 | William Michael Weiss I | Registered Nurse | 2148 Vadalabene Dr, Maryville, IL 62062-5632 | 2016-09-01 |
| 1497115315 | Kolin Smith | Counselor | 2148 Vadalabene Dr, Maryville, IL 62062-5632 | 2016-03-04 |
| 1750740544 | Larry Copp | Counselor | 2148 Vadalabene Dr, Maryville, IL 62062-5632 | 2016-02-22 |
| 1750719142 | Courtney L Hupp | Counselor | 2148 Vadalabene Dr, Maryville, IL 62062-5632 | 2013-10-22 |
| 1568719797 | Daniel Douglas Hutchison | Counselor | 2148 Vadalabene Dr, Maryville, IL 62062-5632 | 2012-08-07 |
| 1952677510 | Tracey Sue Pearson | Counselor | 2148 Vadalabene Dr, Maryville, IL 62062-5632 | 2012-03-28 |
| 1518232891 | Jamie Lee Garman | Counselor | 2148 Vadalabene Dr, Maryville, IL 62062-5632 | 2012-03-20 |
| 1033484449 | Victoria Ann Liston | Social Worker | 2148 Vadalabene Dr, Maryville, IL 62062-5632 | 2012-03-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
| 1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
| 1104348085 | Lindsey Nicole Langendorf | Chiropractor | 62 Executive Plaza Ct, Maryville, IL 62062 | 2017-07-12 |
| 1043750540 | Gina Saal | Nurse Anesthetist, Certified Registered | 6800 Rt 162, Maryville, IL 62062 | 2017-03-02 |
| 1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
| 1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
| 1538438445 | Casey Elizabeth Wiesemeyer | Speech-Language Pathologist | 2201 Copper Creek Rd, Maryville, IL 62062 | 2011-12-21 |
| 1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
| 1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
| 1669782397 | Purandhri Patel | Physical Therapist | 6820 State Route 162, Maryville, IL 62062 | 2010-10-15 |
| Find all providers in zip 62062 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134732696 | Anna Lynn Gallo | Social Worker | 702 Grandview Dr, Maryville, TN 37803-5306 | 2020-08-25 |
| 1861851875 | Amy Haerr | Social Worker | 2135 N Center St, Maryville, IL 62062-2025 | 2016-02-18 |
| 1356737787 | Bethany Minser Love | Social Worker | 4527 Gribble Rd, Maryville, TN 37803-1827 | 2015-04-13 |
| 1457796765 | Brandi Garlich | Social Worker | 3 Oak Dr Ste B, Maryville, IL 62062-5635 | 2013-05-01 |
| 1629336177 | Kristi Renee White | Social Worker | 423 N Market St, Maryville, MO 64468 | 2012-05-02 |
| 1972873289 | Sarah Buchanan | Social Worker | 309 N Houston St, Maryville, TN 37801-4733 | 2012-01-03 |
| 1316223886 | Sabrina Nicole Powers | Social Worker | 1704 East Broadway, Maryville, TN 37804 | 2011-10-28 |
| 1285871160 | Christine Marie Jacobson | Social Worker | 106 W Edwards St, Maryville, MO 64468-2419 | 2009-01-14 |
| 1760644231 | Sabrina Lepkofker | Social Worker | 113 S Maple St, Maryville, TN 37803-5766 | 2008-06-26 |
| 1033302674 | Shannon W Brown | Social Worker | 547 W. Lamar Alexander Parkway, Maryville, TN 37801-4760 | 2007-08-27 |
| Find all providers in MARYVILLE | ||||
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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.