Toya Modeste, | |
1115 Harbor Rd, Grove, OK 74344-3505 | |
(918) 859-8934 | |
Not Available |
Full Name | Toya Modeste |
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Gender | Female |
Speciality | Counselor - Mental Health |
Location | 1115 Harbor Rd, Grove, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1932447000 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 5644 (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 |
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Toya Modeste, 1115 Harbor Rd, Grove, OK 74344-3505 Ph: () - | Toya Modeste, 1115 Harbor Rd, Grove, OK 74344-3505 Ph: (918) 859-8934 |
James Walls, Counselor Medicare: Medicare Enrolled Practice Location: 1115 Harbor Rd, Grove, OK 74344 Phone: 918-786-4434 Fax: 918-786-4435 | |
Theresa R Page-bohannan, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 414 E 3rd St Ste D, Grove, OK 74344 Phone: 918-786-4331 Fax: 918-786-4332 | |
Tina Louise Causey, LCSW Counselor Medicare: Medicare Enrolled Practice Location: 1115 Har-ber Road, Grove, OK 74344 Phone: 844-458-2100 | |
Alexandrea Turner, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1115 Harbor Rd, Grove, OK 74344 Phone: 918-786-4434 | |
Mrs. Modina Pelley, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1115 W. Harber Rd, Grove, OK 74344 Phone: 918-786-4434 | |
Gayle Lynn Dubois, MHR, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 414 E 3rd St, Grove, OK 74344 Phone: 918-480-1744 | |
Amber Marie Dey, Counselor Medicare: Not Enrolled in Medicare Practice Location: 905 E 3rd St, Grove, OK 74344 Phone: 918-787-2104 |