Mr Vince E Maytubby, MA | |
411 S Central Ave, Idabel, OK 74745-6059 | |
(580) 286-7876 | |
(580) 286-5721 |
Full Name | Mr Vince E Maytubby |
---|---|
Gender | Male |
Speciality | Counselor - Mental Health |
Location | 411 S Central Ave, Idabel, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295992261 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 6520 (Oklahoma) | Primary |
Entity Name | Brighter Heights Oklahoma Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063576122 PECOS PAC ID: 5294031167 Enrollment ID: O20240819004343 |
Mailing Address | Practice Location Address |
---|---|
Mr Vince E Maytubby, MA Po Box 1030, Antlers, OK 74523-1030 Ph: (580) 298-2830 | Mr Vince E Maytubby, MA 411 S Central Ave, Idabel, OK 74745-6059 Ph: (580) 286-7876 |
Tina Simer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 17 S Central Ave, Idabel, OK 74745 Phone: 580-286-5184 Fax: 580-286-5185 | |
Catherine White, M.ED, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 503 S Central Ave, Idabel, OK 74745 Phone: 580-212-9193 Fax: 580-286-3478 | |
Kristy Woolsey, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1310 Se Washington St, Idabel, OK 74745 Phone: 580-286-6671 | |
Barbara Sharon Lumsden, LPC, LADC, MBS Counselor Medicare: Not Enrolled in Medicare Practice Location: 411 S Central Ave, Idabel, OK 74745 Phone: 580-286-5045 | |
George Donald Haslam Sr., Counselor Medicare: Not Enrolled in Medicare Practice Location: 411 S Central Ave, Idabel, OK 74745 Phone: 580-286-5045 | |
Corey Griffin, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 116 Se Ave N, Idabel, OK 74745 Phone: 580-286-6671 Fax: 580-286-5747 | |
Brandy T Hickerson, MED, PSYCHOLOGIST Counselor Medicare: Not Enrolled in Medicare Practice Location: 17 S Central Ave, Idabel, OK 74745 Phone: 580-286-5184 Fax: 580-286-5185 |