RUSS KINKADE, PSY.D., S.C. (NPI# 1992195192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992195192 |
Entity Type | Organization |
Organization Name | RUSS KINKADE, PSY.D., S.C. |
Practice Address |
6214 Washington Ave C-10 Mount Pleasant WI 53406-3986 |
Mailing Address |
S55w29307 Holiday Point Dr Waukesha WI 53189-9026 |
Practice Telephone | 2629895228 |
Practice Fax Number | 2628789285 |
Mailing Telephone | 2629895228 |
Mailing Fax Number | 2628789285 |
Enumeration Date | 2015-01-27 |
Last Update Date | 2015-01-27 |
Authorized Official Name | DR. RUSSELL WILLIAM KINKADE JR. (PRESIDENT) |
Authorized Official Telephone | 2629895228 |
Authorized Official Credential | PSY.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261Q00000X | Clinic/Center | 1296 | WI | Ambulatory Health Care Facilities |
Street Address |
6214 WASHINGTON AVE C-10 |
City | MOUNT PLEASANT |
State | WI |
Zip Code | 53406-3986 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467588590 | Barbara B Mizer | Social Worker | 6214 Washington Ave, Suite C10, Mount Pleasant, WI 53406-3986 | 2007-02-25 |
1629696083 | Barbara Gail Demilio | Social Worker | 6214 Washington Ave, Mount Pleasant, WI 53406-3986 | 2020-07-10 |
1811388721 | Nulife Therapy Services, LLC | Community/Behavioral Health | 6214 Washington Ave, Suite C-3, Mount Pleasant, WI 53406-3986 | 2015-02-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578164349 | Lynn Huynh | Pharmacist | 5695 Washington Ave, Racine, WI 53406 | 2020-11-06 |
1659920049 | Carol Jean Cornejo | Technician | 6528 Heritage Avenue, Mt Pleasant, WI 53406 | 2019-09-09 |
1265913958 | Mary Goldbeck | Social Worker | 1775 Newman Rd, Mt Pleasant, WI 53406 | 2018-08-22 |
1669963344 | Kelly Nicole Nelson | Registered Nurse | 8800 Washington Ave Ste 200, Mount Pleasant, WI 53406 | 2018-05-29 |
1891212163 | Ilona Agata Pryomski | Nurse Practitioner | 9201 Washington Ave, Racine, WI 53406 | 2017-08-27 |
1386185106 | Margaret M. Abaogye Dds | Dentist | 4340 Newman Rd., Racine, WI 53406 | 2017-03-13 |
1508309212 | Rebecca Koeppen | Dietitian, Registered | 8400 Washington Ave., Racine, WI 53406 | 2016-11-29 |
1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
1861841470 | Leah Marie Johnson | Dentist | 1101 South Airline Road, Racine, WI 53406 | 2016-06-06 |
Find all providers in zip 53406 |
Taxonomy Code | 261Q00000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750865622 | Merge Medical Analytics | Clinic/Center | 180 Wingo Way Ste 106, Mount Pleasant, SC 29464-1810 | 2018-09-18 |
1720444524 | Therapy Learning Center, East Texas Clinic | Clinic/Center | 910 Holly Hill Ln, Mount Pleasant, TX 75455-5865 | 2016-01-08 |
1073892873 | Imagine Chiropractic PC | Clinic/Center | 952 Houston Northcutt Blvd, Suite 201, Mount Pleasant, SC 29464-5659 | 2011-08-10 |
1952619116 | Rabin Chiropractic Center | Clinic/Center | 712 S Shelmore Blvd, 105, Mount Pleasant, SC 29464-3449 | 2010-09-21 |
1255526141 | Charleston Midwife Services | Clinic/Center | 1300 Hospital Dr Ste 270, Mount Pleasant, SC 29464-3244 | 2007-09-13 |
1639568231 | Mount Pleasant Pediatric Therapy | Clinic/Center | 85 Vincent Dr # C, Mount Pleasant, SC 29464-4066 | 2015-01-20 |
1194065920 | Dr. Addison B. Nelson LLC | Clinic/Center | 874 Whipple Rd, 200, Mount Pleasant, SC 29464-8900 | 2013-02-14 |
1194009563 | 5 Elements Health & Wellness, LLC | Clinic/Center | 1524 S Green Bay Rd, Back In Action/5 Elements, Mount Pleasant, WI 53406-5788 | 2011-10-04 |
1417150186 | Belle Hall Chiropractic, LLC | Clinic/Center | 721 Long Point Rd, Suite 403, Mount Pleasant, SC 29464-8297 | 2007-06-08 |
1861605537 | Tlc The Laser Center (institute) Inc. | Clinic/Center | 709 Long Point Rd, Ste C, Mount Pleasant, SC 29464-8287 | 2007-05-08 |
Find all providers in MOUNT PLEASANT |
City | MOUNT PLEASANT |
Zip Code | 53406 |
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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.