Mary Kelly Moore Lackey, | |
3080 W 3rd St, Elk City, OK 73644-4323 | |
(405) 424-7711 | |
Not Available |
Full Name | Mary Kelly Moore Lackey |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 3080 W 3rd St, Elk City, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326200437 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Entity Name | Oklahoma Mental Health Council |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275574907 PECOS PAC ID: 3173514387 Enrollment ID: O20040518001034 |
Mailing Address | Practice Location Address |
---|---|
Mary Kelly Moore Lackey, Po Box 99, Thomas, OK 73669-0099 Ph: (806) 613-4885 | Mary Kelly Moore Lackey, 3080 W 3rd St, Elk City, OK 73644-4323 Ph: (405) 424-7711 |
Tiffany Kamile Mendez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3080 W 3rd St, Elk City, OK 73644 Phone: 580-225-5136 | |
Andle Temple, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3080 W 3rd St, Elk City, OK 73644 Phone: 580-225-5136 Fax: 580-225-5138 | |
Dodie Jane Mcintyre, Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 S. Monroe Ste 5, Elk City, OK 73644 Phone: 580-729-0422 | |
Miss Randi Dawn Boyer, B.S.W., BHRS, CM-A Counselor Medicare: Not Enrolled in Medicare Practice Location: 3080 W 3rd St, Elk City, OK 73644 Phone: 580-225-5136 Fax: 580-225-5138 | |
Mary F Parkhurst, LPC LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1021 E Highway 66, Elk City, OK 73644 Phone: 580-225-4337 Fax: 580-225-4338 | |
Cierra Burks, M.ED Counselor Medicare: Not Enrolled in Medicare Practice Location: 400 Kimberly Dr, Elk City, OK 73644 Phone: 580-571-7798 | |
Ms. Peggy S Puckett, MS, LPC-CANDIDATE Counselor Medicare: Not Enrolled in Medicare Practice Location: 213 W Broadway Ave, Elk City, OK 73644 Phone: 580-774-2418 |