Johnny Duane Green, | |
105 Plaza, Madill, OK 73446-2248 | |
(580) 795-7439 | |
Not Available |
Full Name | Johnny Duane Green |
---|---|
Gender | Male |
Speciality | Counselor |
Location | 105 Plaza, Madill, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831411263 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Primary |
Entity Name | Lighthouse Behavioral Wellness Centers |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1518997097 PECOS PAC ID: 6406748961 Enrollment ID: O20040329000653 |
Mailing Address | Practice Location Address |
---|---|
Johnny Duane Green, Po Box 1427, Ardmore, OK 73402-1427 Ph: (580) 277-5423 | Johnny Duane Green, 105 Plaza, Madill, OK 73446-2248 Ph: (580) 795-7439 |
Amy Robbins, Counselor Medicare: Not Enrolled in Medicare Practice Location: 221 Plaza, Madill, OK 73446 Phone: 580-795-7444 | |
Mrs. Danah Renae Martin, PSRS Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 Plaza, Madill, OK 73446 Phone: 580-795-7439 | |
Mr. Patrick Mccain, Counselor Medicare: Not Enrolled in Medicare Practice Location: 14330 Gary Rd, Madill, OK 73446 Phone: 580-798-7790 | |
Judy Gayle Nabors, M.ED. LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 Plaza, Madill, OK 73446 Phone: 580-795-7439 Fax: 580-795-7444 | |
Michael Crutchfield, BA BHRS Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 Plaza, Madill, OK 73446 Phone: 580-795-7443 | |
Kathryn Stowe, Counselor Medicare: Not Enrolled in Medicare Practice Location: 605 S 1st St, Madill, OK 73446 Phone: 580-795-3794 | |
Mrs. Victoria Ellen Marshall, BHRS Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 Plaza, Madill, OK 73446 Phone: 580-795-7439 |