KENNESAW STATE UNIVERSITY HEALTH CLINIC (NPI# 1831426931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831426931 |
| Entity Type | Organization |
| Organization Name | KENNESAW STATE UNIVERSITY HEALTH CLINIC |
| Practice Address |
1000 Chastain Rd Nw House 52 Kennesaw GA 30144-5588 |
| Practice Telephone | 7704236644 |
| Mailing Telephone | 7704236644 |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2009-11-10 |
| Authorized Official Name | ANNE NICHOLS (HEALTH CLINIC DIRECTOR) |
| Authorized Official Telephone | 7704236644 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QS1000X |
Clinic/Center Specialization: Student Health |
RN057224 | GA | Ambulatory Health Care Facilities |
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
RN057224 | GA | Ambulatory Health Care Facilities |
| Street Address |
1000 CHASTAIN RD NW HOUSE 52 |
| City | KENNESAW |
| State | GA |
| Zip Code | 30144-5588 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619180676 | Anne Nichols | Nurse Practitioner | 1000 Chastain Rd Nw, Mailstop 5200, Kennesaw, GA 30144-5588 | 2007-05-07 |
| 1518207612 | Kennesaw State University | Clinic/Center | 1000 Chastain Rd Nw, Md5200 House 52, Kennesaw, GA 30144-5588 | 2013-02-26 |
| 1346512357 | Lisa Marie Schulte | Internal Medicine | 1000 Chastain Rd Nw, Mailbox 0201, Kennesaw, GA 30144-5588 | 2012-02-07 |
| 1396057808 | Hiroki Kariya | Specialist/Technologist | 1000 Chastain Rd Nw, Kennesaw, GA 30144-5588 | 2010-07-13 |
| 1003050576 | Lisa Vivienne Poling | Nurse Practitioner | 1000 Chastain Rd Nw, Kennesaw, GA 30144-5588 | 2009-04-28 |
| 1881853026 | Susan Alice Ristau | Counselor | 1000 Chastain Rd Nw, Kennesaw Hall, Suite 2419, Kennesaw, GA 30144-5588 | 2008-06-03 |
| 1750579876 | Gwen Hatley Whiting | Student in an Organized Health Care Education/Training Program | 1000 Chastain Rd Nw, #5200 House #52, Kennesaw, GA 30144-5588 | 2007-10-15 |
| 1104019801 | Lisa Schlageter Stadalius | Nurse Practitioner | 1000 Chastain Rd Nw, 52, Kennesaw, GA 30144-5588 | 2007-08-26 |
| 1932312899 | Emma M. Guice | Nurse Practitioner | 1000 Chastain Rd Nw, House 52, Student Health Clinic, Kennesaw, GA 30144-5588 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205440054 | Physician Assistant Surgical Solutions | Surgery | 4290 Bells Ferry Road, Suite 134 - 1032, Kennesaw, GA 30144 | 2020-08-31 |
| 1487149340 | Creative Family Care Inc. | Social Worker | 1275 Shiloh Rd Nw Ste 3030, Kennesaw, GA 30144 | 2018-06-24 |
| 1033632203 | Octavio Andres Tobar | Specialist/Technologist | 1950 Barrett Lakes Blvd Nw Apt 1213, Kennesaw, GA 30144 | 2017-07-19 |
| 1851829220 | Sharon Mcmillan | Counselor | 1301 Shiloh Rd Nw Ste 1840, Kennesaw, GA 30144 | 2017-05-31 |
| 1073054680 | Metropolitan Health Care Plus Inc | Home Health | 445 Laurian Way, Kennesaw, GA 30144 | 2017-03-15 |
| 1649627969 | Caresouth Hha Holdings of Gainesville, LLC | Hospice Care, Community Based | 1000 Cobb Place Blvd Nw Ste 310, Kennesaw, GA 30144 | 2016-05-17 |
| 1851745988 | Joseph Mulligan | Social Worker | 1301 Shiloh Rd., Ste. 849, Kennesaw, GA 30144 | 2016-04-14 |
| 1629438601 | Youfit Health Clubs | Clinic/Center | 3895 Cherokee St Suite 100, Kennesaw, GA 30144 | 2016-03-03 |
| 1598156317 | Jodie Evans | Specialist | 1925 Vaughn Rd, Ste 200, Kennesaw, GA 30144 | 2015-02-16 |
| 1912302134 | Sleepmed Therapies, Inc. | Durable Medical Equipment & Medical Supplies | 1000 Cobb Place Blvd Nw Ste 510, Kennesaw, GA 30144 | 2014-10-30 |
| Find all providers in zip 30144 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700491172 | Life Compass Mental Health Services, LLC | Clinic/Center | 300 Colnl Ctr Pkwy Ste 100n, Roswell, GA 30076-4892 | 2020-09-12 |
| 1104437987 | Mimi Mcdonald LLC | Clinic/Center | 408 Creekstone Rdg, Woodstock, GA 30188-3740 | 2020-08-13 |
| 1396353884 | Atlanta Mental Wellness LLC | Clinic/Center | 1535 Mount Vernon Rd Ste B, Dunwoody, GA 30338-4149 | 2020-07-21 |
| 1982212536 | Living Well Integrative Counseling, LLC | Clinic/Center | 245 N Highland Ave Ne Ste 230-285, Atlanta, GA 30307-1936 | 2020-07-20 |
| 1841808060 | By Grace Counseling LLC | Clinic/Center | 100 Hemingway Ln, Roswell, GA 30075-7024 | 2020-07-14 |
| 1245854371 | Synergia Integrated Telebehavioral Health | Clinic/Center | 3941 Old Atlanta Station Drive, Southeast, Atlanta, GA 30339 | 2020-06-04 |
| 1164055455 | New Perspectives Psychotherapy LLC | Clinic/Center | 10 N Clarendon Ave Ste B, Avondale Estates, GA 30002-1165 | 2020-02-15 |
| 1982234423 | All About You Counseling, LLC | Clinic/Center | 150 Prospect Pl, Alpharetta, GA 30005-5445 | 2020-01-23 |
| 1295372225 | Mental Space LLC | Clinic/Center | 4210 Columbia Rd Unit D, Martinez, GA 30907-0401 | 2019-12-10 |
| 1225679921 | Jacqueline Pickett Parrish | Clinic/Center | 3511 Willow Tree Trce, Decatur, GA 30034-3842 | 2019-10-03 |
| Find all providers with the same taxonomy | ||||
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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.