MRS. IDA MAE SUTTMOLLER (NPI# 1912133323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912133323 |
| Entity Type | Individual |
| Full Name | MRS. IDA MAE SUTTMOLLER |
| Credential | MA LCSW CASAC |
| Practice Address |
108 West Jasper Versailles MO 65084 |
| Mailing Address |
108 West Jasper Versallies MO 65084 |
| Practice Telephone | 5733786833 |
| Practice Fax Number | 5733786823 |
| Mailing Telephone | 5733786833 |
| Mailing Fax Number | 5733786823 |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2009-06-01 |
| 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) |
868 | MO | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
003970 | MO | Behavioral Health & Social Service Providers |
| Street Address |
108 WEST JASPER |
| City | VERSAILLES |
| State | MO |
| Zip Code | 65084 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295123420 | Erin Eggen | Nursing Facility/Intermediate Care Facility | 1101 Clay Street, Versailles, MO 65084 | 2014-12-22 |
| 1053694422 | Regional Health Care Clinic, Inc | Clinic/Center | 1109 Clay Rd., Versailles, MO 65084 | 2011-09-22 |
| 1649453408 | Kidwell Home | Assisted Living Facility | 1000 Kidwell Drive, Versailles, MO 65084 | 2007-12-14 |
| 1558480640 | Diana Moree Burdick | Nurse Practitioner | 102 North Fisher, Versailles, MO 65084 | 2007-03-28 |
| 1245370923 | Integrity Lifeskills LLC | Psychologist | Bremond St 506, Versailles, MO 65084 | 2007-02-08 |
| 1831250497 | Paul Howard | Family Medicine | 901 Kidwell Drive, Versailles, MO 65084 | 2006-12-13 |
| 1275570863 | Doris Elliott | Counselor | 112 N Highway 5, Versailles, MO 65084 | 2006-06-01 |
| 1730167164 | Frederick Michael Schekorra | Family Medicine | 901 Kidwell, Capital Region Medical Clinic Versailles, Versailles, MO 65084 | 2006-01-05 |
| 1659356731 | Nora Stephan Appelbaum | Nurse Practitioner | 1109 W Clay Rd, Versailles, MO 65084 | 2005-12-12 |
| 1447257571 | Susan Mary Burkhart | Family Medicine | 801 Kidwell Drive, St Mary's Clinic, Versailles, MO 65084 | 2005-07-05 |
| Find all providers in zip 65084 | ||||
| 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 |
|---|---|---|---|---|
| 1700494598 | Bluegrass Behavioral Health Services LLC | Social Worker | 501 Marsailles Rd Ste 3, Versailles, KY 40383-1911 | 2020-07-17 |
| 1023191335 | Andrea Kelly Sparrow | Social Worker | 220 Frankfort St Ste 1, Versailles, KY 40383-1079 | 2006-10-23 |
| 1689222150 | Ashley A Piercy | Social Worker | 125 Big Sink Rd Ste B, Versailles, KY 40383-1956 | 2019-08-28 |
| 1235624800 | Everhart-harmon Counseling Services | Social Worker | 163 Spring Run St, Versailles, KY 40383-1803 | 2018-06-26 |
| 1295158004 | Caitlin Covington Bryant | Social Worker | 2050 Lexington Rd, Versailles, KY 40383-1738 | 2014-01-30 |
| 1457605131 | Regional Health Care Clinic, Inc | Social Worker | 913 W Newton St, Versailles, MO 65084-1811 | 2012-11-02 |
| 1023029832 | Angela M. Ross | Social Worker | 1109 W Clay Rd, Versailles, MO 65084 | 2006-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447701 | Constance Fulks | Social Worker | 1141 Wooden Dr, Florissant, MO 63033-5954 | 2020-11-03 |
| 1447850870 | Convergence Counseling Services, LLC | Social Worker | 7612 E 113th St, Kansas City, MO 64134-2946 | 2020-10-26 |
| 1336748599 | Meghan Lyn Mallams | Social Worker | 28 Westwoods Dr Ste 107, Liberty, MO 64068-3520 | 2020-10-20 |
| 1639777154 | Keisa D. Baker | Social Worker | 7716 Arlington Ave, Raytown, MO 64138-1654 | 2020-10-16 |
| 1811595697 | Sarah Nicole Bailey | Social Worker | 27759 Rock Ave, Bell City, MO 63735-8111 | 2020-10-13 |
| 1629676929 | Katrina Louise Routh | Social Worker | 1310 E Kingsley St Ste B, Springfield, MO 65804-7238 | 2020-10-09 |
| 1184221368 | Deborah L Tannenbaum, Lcsw, LLC | Social Worker | 3000 Arrow Rock Dr, Saint Charles, MO 63303-6502 | 2020-10-01 |
| 1407463706 | Allison Nichole Kemble | Social Worker | 806 Shawn Ct, Centralia, MO 65240-4320 | 2020-09-30 |
| 1336756949 | Megan Krystal Draper | Social Worker | 8425 Locust St, Kansas City, MO 64131-2223 | 2020-09-28 |
| 1730796541 | Angelita Pritchett | Social Worker | 908 Glencoe, Park Hills, MO 63601-1931 | 2020-09-25 |
| Find all providers with the same taxonomy | ||||
| City | VERSAILLES |
| Zip Code | 65084 |
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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.