Avery Joel Fennell, is a
Peer Specialist based in Oklahoma City, Oklahoma. Avery Joel Fennell is licensed to practice in Oklahoma (license number ) and his current practice location is
2617 General Pershing Blvd, Oklahoma City, Oklahoma. He can be reached at his office (for appointments etc.) via phone at
(405) 858-2700.
NPI number for Avery Joel Fennell is 1013650225 and his current mailing address is Po Box 12978, Oklahoma City, Oklahoma. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1013650225.
Healthcare Provider's Profile
| Full Name | Avery Joel Fennell |
|---|
| Gender | Male |
|---|
| Speciality | Peer Specialist |
|---|
| Location | 2617 General Pershing Blvd, Oklahoma City, Oklahoma |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1013650225
- Provider Enumeration Date: 04/15/2022
- Last Update Date: 04/22/2022
Medical Identifiers
Medical identifiers for Avery Joel Fennell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013650225 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (Oklahoma) | Secondary |
| 101YM0800X | Counselor - Mental Health | (Oklahoma) | Secondary |
| 175T00000X | Peer Specialist | (Oklahoma) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Avery Joel Fennell is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Avery Joel Fennell,
Po Box 12978,
Oklahoma City, OK 73157-2978
Ph: () - | Avery Joel Fennell,
2617 General Pershing Blvd,
Oklahoma City, OK 73107-6437
Ph: (405) 858-2700 |
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