Ms Tammy Jo Coletta, | |
8422 N 123rd East Ave, Owasso, OK 74055-2130 | |
(918) 858-4353 | |
Not Available |
Full Name | Ms Tammy Jo Coletta |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 8422 N 123rd East Ave, Owasso, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376766972 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | LPC.0005606 (Colorado) | Primary |
101YA0400X | Counselor - Addiction (substance Use Disorder) | ACD.0000498 (Colorado) | Secondary |
Entity Name | Pine Ridge Mental Healthcare, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346828050 PECOS PAC ID: 2062812043 Enrollment ID: O20210614000169 |
Mailing Address | Practice Location Address |
---|---|
Ms Tammy Jo Coletta, 8422 N 123rd East Ave, Owasso, OK 74055-2130 Ph: (918) 858-4353 | Ms Tammy Jo Coletta, 8422 N 123rd East Ave, Owasso, OK 74055-2130 Ph: (918) 858-4353 |
Susan Renee Terhune, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 10577 N 121st East Ave, Owasso, OK 74055 Phone: 918-859-6622 | |
James Schnorrenberg, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10100 N Garnett Rd, Owasso, OK 74055 Phone: 918-289-5614 | |
Ms. Teresa Gail Doss Stewart, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8959 N 133rd East Ave, Owasso, OK 74055 Phone: 918-625-8655 | |
Laurel Stouffer, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 12906 E 106th St N, Owasso, OK 74055 Phone: 918-214-3804 Fax: 918-376-4586 | |
Ms. Barbara Roberts Bold, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 9017 N 100th East Ave, Owasso, OK 74055 Phone: 918-272-1413 | |
Jenifer Nold, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 10310 N 138th East Ave Ste 101, Owasso, OK 74055 Phone: 539-210-3847 | |
Mary Thomas, Counselor Medicare: Not Enrolled in Medicare Practice Location: 9800 N 100th East Ave, Owasso, OK 74055 Phone: 918-609-3006 |