Diane B Hamilton, LPC | |
405 E Excelsior Ave, Vinita, OK 74301-4226 | |
(918) 256-6476 | |
(918) 256-3628 |
Full Name | Diane B Hamilton |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 405 E Excelsior Ave, Vinita, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1205056496 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 3268 (Oklahoma) | Primary |
Entity Name | Grand Lake Mental Health Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1497762520 PECOS PAC ID: 4688711534 Enrollment ID: O20091026000174 |
Mailing Address | Practice Location Address |
---|---|
Diane B Hamilton, LPC 405 E Excelsior Ave, Vinita, OK 74301-4226 Ph: (918) 256-6476 | Diane B Hamilton, LPC 405 E Excelsior Ave, Vinita, OK 74301-4226 Ph: (918) 256-6476 |
Chrystal Brassfield, MS Counselor Medicare: Medicare Enrolled Practice Location: 405 E Excelsior Ave, Vinita, OK 74301 Phone: 918-256-6476 Fax: 918-256-3628 | |
Anthony Goodell, Counselor Medicare: Not Enrolled in Medicare Practice Location: 405 E Excelsior Ave, Vinita, OK 74301 Phone: 918-256-6476 Fax: 918-256-3628 | |
Melanie K Phillips, Counselor Medicare: Not Enrolled in Medicare Practice Location: 405 East Excelsior, Vinita, OK 74301 Phone: 918-256-6476 Fax: 918-256-3628 | |
Dorsey Ramsey, BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 405 East Excelsior, Vinita, OK 74301 Phone: 918-256-6476 Fax: 918-256-3628 | |
Betty F Showler, MAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 22253 S 4370 Rd, Vinita, OK 74301 Phone: 918-244-6416 | |
Jonathan Brodrick, Counselor Medicare: Not Enrolled in Medicare Practice Location: 405 E Excelsior Ave, Vinita, OK 74301 Phone: 918-256-6476 Fax: 918-256-3628 | |
Mrs. Shalaina Dunn, MA, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 405 E Excelsior Ave, Vinita, OK 74301 Phone: 844-458-2100 Fax: 918-256-9890 |