John Patrick Chervenak, M.R.C., C.R.C., L.P.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2004011118 Issued in MO

Practice address

1906 Greenwood Dr # B
Poplar Bluff, MO 63901-2430

Phone

(573) 778-0705

Fax

(573) 778-0925

NPI assigned

Aug 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• John O. Wood Psychological Services

  • Community/Behavioral Health Agency
  • Poplar Bluff, MO
  • NPI 1346560869
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649385469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 SEIFERT DR",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012555",
            "telephone_number": "573-686-6453",
            "fax_number": "573-686-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 GREENWOOD DR # B",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012430",
            "telephone_number": "573-778-0705",
            "fax_number": "573-778-0925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERVENAK",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "credential": "M.R.C., C.R.C., L.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2004011118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josielyn Charity Chase
• Tracy Leigh Chatat, MSW
• Matthew Chatman, FNP
• Kaylee Nicole Cheek
• Imran Q Cheema, M.D.
• Children's Clinic
• Patricia Irene Chinburg
• Chiropractic Life Center Poplar Bluff PC
• Nichole Lynn Chism
• Shahid K Choudhary, M.D.

• Professional Counselor in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.