KAYLA LYNN FAZZARI (NPI# 1891313656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1891313656 |
Entity Type | Individual |
Full Name | KAYLA LYNN FAZZARI |
Credential | LPC, SAC-IT |
Practice Address |
N168w20964 Main St Jackson WI 53037-9634 |
Practice Telephone | 2625104332 |
Mailing Telephone | 2625104332 |
Enumeration Date | 2020-07-08 |
Last Update Date | 2020-07-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
18558-130 | WI | Behavioral Health & Social Service Providers |
Y | 101YP2500X |
Counselor Specialization: Professional |
7720-125 | WI | Behavioral Health & Social Service Providers |
Street Address |
N168W20964 MAIN ST |
City | JACKSON |
State | WI |
Zip Code | 53037-9634 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598377905 | Nohc Jackson Senior Living LLC | Assisted Living Facility | N16744 Eagle Drive, Jackson, WI 53037 | 2020-08-18 |
1467996991 | Children's Medical Group | Pediatrics | N168w22730 Prairie View Lane, Jackson, WI 53037 | 2016-12-19 |
1700176682 | Lincoln Healthcare, Inc | Home Health | W227n16841 Tillie Lake Court, Jackson, WI 53037 | 2011-04-13 |
1023211380 | Laura Jean Steinmetz | Licensed Practical Nurse | N170 W20309 Hunters Rd, Jackson, WI 53037 | 2007-06-06 |
1073722724 | Peter Christian Labudde | Dentist | N168 W20566 Main St, Jackson, WI 53037 | 2007-05-21 |
1104952597 | Judith Barbara Miller | Registered Nurse | 3114 Sherman Parc Circle, Jackson, WI 53037 | 2007-02-27 |
1548395684 | Joan Alice Heath | Registered Nurse | N168w21700 Main St Lot 122, Jackson, WI 53037 | 2007-02-22 |
1578511739 | Carol Lynn Radovich | Nurse Practitioner | W197n17054 Stonewall Dr, Jackson, WI 53037 | 2006-05-04 |
1699752907 | Zhaleh Barari | Optometrist | W194 N 16747 Eagle Dr., Suite N, Jackson, WI 53037 | 2005-12-28 |
1790399780 | Jackson Town & Country Dental LLC | Dentist | N168 W20566 Main St, Jackson, WI 53037 | 2020-09-07 |
Find all providers in zip 53037 |
Taxonomy Code | 101YP2500X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Professional |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902411663 | Kristen Camille Kapler | Counselor | 3899 Division Rd, Jackson, WI 53037-9707 | 2020-09-10 |
1992339071 | Open Door Family Counseling | Counselor | 316 S Brown St Ste A, Jackson, MI 49203-1481 | 2020-02-27 |
1891334108 | Jamie Alane Merrill | Counselor | 1214 Greenwood Ave, Jackson, MI 49203-3037 | 2020-01-03 |
1285273078 | Hall Consulting Services LLC | Counselor | 1155 Briarwood Dr, Jackson, MS 39211-4204 | 2019-12-27 |
1114496387 | New Direction Counseling Center, LLC | Counselor | 1200 N West Ave Ste 809, Jackson, MI 49202-2196 | 2018-11-17 |
1811490964 | Lifeworks Resources, LLC | Counselor | 575 S Royal St Ste 24, Jackson, TN 38301-7307 | 2018-03-15 |
1912409764 | Impact Behavioral Counseling LLC | Counselor | 1551 E County Line Rd Ste B, Jackson, MS 39211-1801 | 2018-03-07 |
1831697317 | Denise June Johnson | Counselor | 906 Lincoln St, Jackson, MI 49202-3251 | 2018-01-30 |
1033626031 | Heather R. Chruch | Counselor | 180 W Michigan Ave Ste 204, Jackson, MI 49201-1342 | 2017-12-29 |
1861908337 | Matthew T Tompkins | Counselor | 810 E Jackson Blvd Ste B1, Jackson, MO 63755-2400 | 2017-12-20 |
Find all providers in JACKSON |
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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.