CAROLYN JEAN HENDRICKS (NPI# 1952557647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952557647 |
| Entity Type | Individual |
| Full Name | CAROLYN JEAN HENDRICKS |
| Other Name | CAROLYN JEAN GONTER |
| Credential | M.D. |
| Practice Address |
1881 Chicago St De Pere WI 54115-3770 |
| Practice Telephone | 9204038209 |
| Mailing Telephone | 9204038209 |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2015-07-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
63706 | WI | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
53895 | MN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | ENROLLED | 05 | |
| IA | ENROLLED | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528142262 | Carolyn Gaines Hendricks | Nurse Practitioner | 3110 Clifton Springs Rd, Suite D, Decatur, GA 30034-4600 | 2006-10-25 |
| 1205896776 | Carolyn Bennett Hendricks | Specialist | 6410 Rockledge Dr, Suite 506, Bethesda, MD 20817-1809 | 2006-03-27 |
| Street Address |
1881 CHICAGO ST |
| City | DE PERE |
| State | WI |
| Zip Code | 54115-3770 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174561120 | Yoloxochitl Diaz | Pediatrics | 1881 Chicago St, De Pere, WI 54115-3770 | 2006-06-03 |
| 1871006536 | Robert C Reff | Counselor | 1881 Chicago St, De Pere, WI 54115-3770 | 2017-11-15 |
| 1508379405 | Denise C Klubertanz-berge | Nurse Practitioner | 1881 Chicago St, De Pere, WI 54115 | 2017-11-14 |
| 1629502513 | Elaine Melissa Aquino | Internal Medicine | 1881 Chicago St, De Pere, WI 54115-3770 | 2017-04-18 |
| 1497187298 | Leah Michelle Brittnacher | Counselor | 1881 Chicago St, De Pere, WI 54115-3770 | 2013-08-02 |
| 1952699217 | Shelli A Meyer | Nurse Practitioner | 1881 Chicago St, De Pere, WI 54115 | 2011-07-20 |
| 1750675963 | Jonathan M Hendricks | Psychiatry & Neurology | 1881 Chicago St, De Pere, WI 54115-3770 | 2011-06-06 |
| 1023329042 | Manisha Chaturvedi | Family Medicine | 1881 Chicago St, De Pere, WI 54115-3770 | 2010-06-24 |
| 1609193028 | Jyoti Brar | Internal Medicine | 1881 Chicago St, De Pere, WI 54115-3770 | 2010-04-25 |
| 1386807170 | Ines C Pacurar | Pediatrics | 1881 Chicago St, De Pere, WI 54115-3770 | 2008-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871138073 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 723 Main Ave, Depere, WI 54115 | 2019-11-12 |
| 1568928083 | Stephanie J Towle | Speech-Language Pathologist | 200 S. 9th St, De Pere, WI 54115 | 2019-02-20 |
| 1164988499 | Maribel L Zoeller | Physical Therapy Assistant | 200 S. 9th Street, Depere, WI 54115 | 2019-02-12 |
| 1255897641 | Elizabeth Eberius | Acupuncturist | 3311 S. Packerland Drive, Suite A #20, De Pere, WI 54115 | 2019-02-11 |
| 1548750458 | Jordyn E Arndt | Physical Therapist | 1601 Lawrence Dr Ste 100, De Pere, WI 54115 | 2018-05-16 |
| 1588153514 | David Nowakowski | Registered Nurse | 158 Cavil Way, De Pere, WI 54115 | 2018-05-04 |
| 1457858557 | Rennes Assisted Living Corp. | Assisted Living Facility | 1150 Lois Street, Depere, WI 54115 | 2018-04-06 |
| 1518473966 | Kirsten Lynne Masrelian | Behavioral Analyst | 2073 Lawrence Dr, De Pere, WI 54115 | 2017-12-21 |
| 1285146050 | Sydney Marie Schultz | Physical Medicine & Rehabilitation | 200 S. Ninth Street, De Pere, WI 54115 | 2017-11-01 |
| 1134666514 | Nicole L Bickham | Psychologist | 416 George St Ste 108, De Pere, WI 54115 | 2017-01-24 |
| Find all providers in zip 54115 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275980799 | Pyrimad Psychiatric Services and Health Care Management Solutions | Psychiatry & Neurology | 2460 Prairie Flower Ln, De Pere, WI 54115-9373 | 2016-05-16 |
| 1194789511 | Randall B Steinhaus | Psychiatry & Neurology | 1325 Angels Path, De Pere, WI 54115-4050 | 2006-04-13 |
| 1750675963 | Jonathan M Hendricks | Psychiatry & Neurology | 1881 Chicago St, De Pere, WI 54115-3770 | 2011-06-06 |
| 1275621807 | Matt Zak | Psychiatry & Neurology | 3860 Monroe Rd, De Pere, WI 54115-8399 | 2006-10-10 |
| 1710999487 | John R Stamm | Psychiatry & Neurology | 1325 Angels Path Rd, De Pere, WI 54115-4050 | 2006-08-12 |
| 1972515658 | Chris N Larson | Psychiatry & Neurology | 1325 Angels Path Rd, De Pere, WI 54115-4050 | 2006-08-12 |
| 1447262191 | Jonathan W Thomas | Psychiatry & Neurology | 1325 Angels Path Rd, De Pere, WI 54115-4050 | 2006-08-12 |
| 1679516355 | Howard W Davis | Psychiatry & Neurology | 1325 Angel's Path, De Pere, WI 54115-4050 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144844069 | Ania Fida | Psychiatry & Neurology | 1900 Westwood Dr, Wausau, WI 54401-7842 | 2020-06-05 |
| 1740764034 | New Frontiers Tms LLC | Psychiatry & Neurology | 2675 N Mayfair Rd Ste 400, Milwaukee, WI 53226-1305 | 2018-09-21 |
| 1912492398 | Heidi Ruth Wohlrabe | Psychiatry & Neurology | 1010 Franklin St, Wausau, WI 54403-5012 | 2018-06-27 |
| 1811494628 | Udoyen Health LLC | Psychiatry & Neurology | 1414 W Park Pl, Suite 202, Milwaukee, WI 53224 | 2018-04-09 |
| 1053811307 | Bret Reynolds | Psychiatry & Neurology | 2000 Progress Road, New Lisbon Correctional Institute-health Services Unit, New Lisbon, WI 53950 | 2018-02-13 |
| 1194223933 | Forefront-holbrook Medical Service Corporation | Psychiatry & Neurology | W315n7677 State Road 83 Unit 20, Hartland, WI 53029-9784 | 2018-01-26 |
| 1972015048 | Suzanne Lee | Psychiatry & Neurology | 1835 Winnebago St. #402, Madison, WI 53704 | 2017-10-30 |
| 1790212603 | Imad Khan | Psychiatry & Neurology | Uw Hospitals & Clinics 600 Highland Avenue, Madison, WI 53792 | 2017-05-23 |
| 1659725497 | Chelsea Maria Sprick | Psychiatry & Neurology | 5000 W National Ave Fl 3, Milwaukee, WI 53295-3133 | 2016-04-18 |
| 1801258579 | Cynthia Di Giandomenico | Psychiatry & Neurology | 411 Stageline Rd Ste 200, Hudson, WI 54016-7848 | 2016-03-22 |
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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.