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| |
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111 S Treaty Rd Miami OK 74354-5327 | |
| (918) 540-1511 | |
| (918) 542-7374 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 111 S Treaty Rd, Miami, Oklahoma |
| Authorized Official Name and Position | Larry Smith (CEO) |
| Authorized Official Contact | 9182731841 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
114 W Delaware Ave Nowata OK 74048-2601 Ph: (918) 540-1511 | 111 S Treaty Rd Miami OK 74354-5327 Ph: (918) 540-1511 |
| NPI Number | 1497762520 |
|---|---|
| Provider Enumeration Date | 08/02/2006 |
| Last Update Date | 06/07/2022 |
| Certification Date | 06/07/2022 |
| Medicare PECOS PAC ID | 4688711534 |
|---|---|
| Medicare Enrollment ID | O20091026000174 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497762520 | NPI | - | NPPES |
| 100732860G | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Christopher M Puls |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376514125 PECOS PAC ID: 1850353392 Enrollment ID: I20050425000817 |
| Provider Name | David L Mcelwain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003928334 PECOS PAC ID: 8628019577 Enrollment ID: I20050718000588 |
| Provider Name | Weldon J Mallgren |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841384021 PECOS PAC ID: 6002983343 Enrollment ID: I20080929000159 |
| Provider Name | Lisa A Seabridge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316969157 PECOS PAC ID: 1456476050 Enrollment ID: I20100920001094 |
| Provider Name | Kimberly Kyoung Hill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962623066 PECOS PAC ID: 8022268226 Enrollment ID: I20121024000659 |
| Provider Name | Tina Causey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063725315 PECOS PAC ID: 4183868581 Enrollment ID: I20130925000854 |
| Provider Name | Khalil Michael Saliba |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679544340 PECOS PAC ID: 0547487175 Enrollment ID: I20140805002728 |
| Provider Name | Peter F Rausch |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790196202 PECOS PAC ID: 1052539848 Enrollment ID: I20140819002323 |
| Provider Name | Tiffany N Tottress |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023245800 PECOS PAC ID: 3375867898 Enrollment ID: I20150109001583 |
| Provider Name | Alyson N Speers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780089250 PECOS PAC ID: 8921313867 Enrollment ID: I20150820011505 |
| Provider Name | Stephanie Heaton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730511684 PECOS PAC ID: 9739470386 Enrollment ID: I20160629000549 |
| Provider Name | Shanda Leigh Holenda |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225444003 PECOS PAC ID: 9830478627 Enrollment ID: I20161118000851 |
| Provider Name | Lisa Michelle Dickson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972919637 PECOS PAC ID: 6800177957 Enrollment ID: I20170103000960 |
| Provider Name | Rebecca Raelynn Bowen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558781542 PECOS PAC ID: 3173896958 Enrollment ID: I20170829003775 |
| Provider Name | Kasandra Lynn Turbett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558745570 PECOS PAC ID: 5991065302 Enrollment ID: I20180202002273 |
| Provider Name | Angela Gale Rhoten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841575230 PECOS PAC ID: 7517227390 Enrollment ID: I20180216001266 |
| Provider Name | Emily Fay Shearer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114392149 PECOS PAC ID: 1951662766 Enrollment ID: I20180219000550 |
| Provider Name | Casey Lea Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558608901 PECOS PAC ID: 9436410289 Enrollment ID: I20180219002452 |
| Provider Name | Mania Hill-u |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750585816 PECOS PAC ID: 2961764295 Enrollment ID: I20180326000445 |
| Provider Name | Jennifer N Pettijohn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295017614 PECOS PAC ID: 1951522622 Enrollment ID: I20180809000974 |
| Provider Name | Jordan Michael Westbrook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174093710 PECOS PAC ID: 1658616024 Enrollment ID: I20181213001776 |
| Provider Name | Christie Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184046211 PECOS PAC ID: 8527392075 Enrollment ID: I20190703000441 |
| Provider Name | Sheri Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700321155 PECOS PAC ID: 6800128406 Enrollment ID: I20191031002086 |
| Provider Name | Jennifer Glenn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295004844 PECOS PAC ID: 3375875990 Enrollment ID: I20191031003006 |
| Provider Name | Mary M Noble |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912318072 PECOS PAC ID: 6709219850 Enrollment ID: I20191204001654 |
| Provider Name | Julia A Summers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174153118 PECOS PAC ID: 1658700471 Enrollment ID: I20200330003749 |
| Provider Name | Alisha Hendren |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982953568 PECOS PAC ID: 1153744693 Enrollment ID: I20200701000272 |
| Provider Name | Bradley Michael Bowden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336529353 PECOS PAC ID: 9537584800 Enrollment ID: I20200803003196 |
| Provider Name | Bryan Rea |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992177521 PECOS PAC ID: 7618264615 Enrollment ID: I20200827002874 |
| Provider Name | Brandy Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962800441 PECOS PAC ID: 9032537469 Enrollment ID: I20200916001165 |
| Provider Name | Mckenzie Henderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679839617 PECOS PAC ID: 4183034408 Enrollment ID: I20201027002837 |
| Provider Name | Johnathan Paul Gordon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760965388 PECOS PAC ID: 8022429380 Enrollment ID: I20201118001493 |
| Provider Name | Caleigh Nichols |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730674508 PECOS PAC ID: 5890107296 Enrollment ID: I20201208002908 |
| Provider Name | Natasha Hamilton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245734839 PECOS PAC ID: 1254744691 Enrollment ID: I20210104002158 |
| Provider Name | Kali Faircloth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487175006 PECOS PAC ID: 0749693521 Enrollment ID: I20210115002220 |
| Provider Name | Brigid Ann Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497986954 PECOS PAC ID: 9133533151 Enrollment ID: I20210202001404 |
| Provider Name | Kelly Meszaros |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942798087 PECOS PAC ID: 6901211861 Enrollment ID: I20210226002052 |
| Provider Name | Jennifer Hicks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669920054 PECOS PAC ID: 8123434073 Enrollment ID: I20210301002750 |
| Provider Name | Dustin Lang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497247142 PECOS PAC ID: 2365859816 Enrollment ID: I20210329001472 |
| Provider Name | Ashley D Knapp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750819975 PECOS PAC ID: 5193133353 Enrollment ID: I20210428001021 |
| Provider Name | Brooke Diane Hensley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477751121 PECOS PAC ID: 7911316153 Enrollment ID: I20210429001417 |
| Provider Name | Tara Garrity |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215246574 PECOS PAC ID: 1557765252 Enrollment ID: I20210803000687 |
| Provider Name | Gretchen Louise Newsom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700012374 PECOS PAC ID: 6709281561 Enrollment ID: I20210818000463 |
| Provider Name | Wendy Myers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306179395 PECOS PAC ID: 5092982801 Enrollment ID: I20210825002024 |
| Provider Name | Brianne Herron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043618234 PECOS PAC ID: 9335538677 Enrollment ID: I20211108002490 |
| Provider Name | Glenetta Laschelle Bradley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972831188 PECOS PAC ID: 7012307465 Enrollment ID: I20211130000093 |
| Provider Name | Syzyline Dada |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386846996 PECOS PAC ID: 0941691216 Enrollment ID: I20211221000404 |
| Provider Name | Benjamin Rendon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194014241 PECOS PAC ID: 3870985815 Enrollment ID: I20220125000039 |
| Provider Name | Lauren Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235445404 PECOS PAC ID: 7810389657 Enrollment ID: I20220127002744 |
| Provider Name | Kortnie Gene Ramos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811668916 PECOS PAC ID: 7214329051 Enrollment ID: I20220127002957 |
| Provider Name | Catharine Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265889778 PECOS PAC ID: 3072906866 Enrollment ID: I20220128002124 |
| Provider Name | Elizabeth Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275284465 PECOS PAC ID: 3678966918 Enrollment ID: I20220208002770 |
| Provider Name | Priscilla Anne Chiquin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225528409 PECOS PAC ID: 6800280017 Enrollment ID: I20220304001598 |
| Provider Name | Katelyn Abrams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073910865 PECOS PAC ID: 7719373760 Enrollment ID: I20220331001203 |
| Provider Name | Chong Vang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962159087 PECOS PAC ID: 4284020785 Enrollment ID: I20220411000525 |
| Provider Name | Shelley Mccarty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922381201 PECOS PAC ID: 2860888278 Enrollment ID: I20220412002640 |
| Provider Name | David Jonathan Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295274462 PECOS PAC ID: 6800216292 Enrollment ID: I20220421001911 |
| Provider Name | Shamaine Woodard - Payton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568019925 PECOS PAC ID: 6305223579 Enrollment ID: I20220510001789 |
| Provider Name | Harmony Michelle Revard Fuller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013433655 PECOS PAC ID: 2365823432 Enrollment ID: I20220720002731 |
| Provider Name | Carrie Deschenes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700308939 PECOS PAC ID: 0042693970 Enrollment ID: I20220810001703 |
| Provider Name | Sophia Lefrere |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215551429 PECOS PAC ID: 0042695975 Enrollment ID: I20220913003765 |
| Provider Name | Tiffany Tomaso-kelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134135395 PECOS PAC ID: 1052642659 Enrollment ID: I20221014001591 |
| Provider Name | Lisa Hoyt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356853725 PECOS PAC ID: 2567839442 Enrollment ID: I20221107000098 |
| Provider Name | Jeremy S Aragon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760723811 PECOS PAC ID: 8022485895 Enrollment ID: I20221108000699 |
| Provider Name | Megan Dixon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205218146 PECOS PAC ID: 1759759764 Enrollment ID: I20221123000939 |
| Provider Name | James Luke Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023661493 PECOS PAC ID: 1254700610 Enrollment ID: I20221207002432 |
| Provider Name | Sarah Hutton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851761068 PECOS PAC ID: 9436528254 Enrollment ID: I20221216001174 |
| Provider Name | Kimberly D Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336857028 PECOS PAC ID: 3375914963 Enrollment ID: I20230118001103 |
| Provider Name | Heather Rosenhamer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376928416 PECOS PAC ID: 0345611299 Enrollment ID: I20230201000428 |
| Provider Name | Sarah Neyman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174276976 PECOS PAC ID: 0345612123 Enrollment ID: I20230203000306 |
| Provider Name | Lauren Bradley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669947453 PECOS PAC ID: 7012381767 Enrollment ID: I20230320000972 |
| Provider Name | Alanna M Mccaskey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790339554 PECOS PAC ID: 6709250343 Enrollment ID: I20230321002272 |
| Provider Name | Melissa Elaine Herst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235840570 PECOS PAC ID: 1052785623 Enrollment ID: I20230322000454 |
| Provider Name | Brogan A'neal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295400745 PECOS PAC ID: 2365816824 Enrollment ID: I20230323001738 |
| Provider Name | Angela Penn-juenger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750778817 PECOS PAC ID: 8729445903 Enrollment ID: I20230602000255 |
| Provider Name | Penny Le Ann Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083142566 PECOS PAC ID: 2567829658 Enrollment ID: I20230605002910 |
| Provider Name | Stephanie Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174131619 PECOS PAC ID: 9234597584 Enrollment ID: I20230620001429 |
| Provider Name | Evelyn Amy Cotten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821563610 PECOS PAC ID: 3678936929 Enrollment ID: I20230905000390 |
| Provider Name | Adair Welsh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407314909 PECOS PAC ID: 8224492095 Enrollment ID: I20230912002785 |
| Provider Name | Rami Kareem Allam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609427608 PECOS PAC ID: 5294180550 Enrollment ID: I20231006002164 |
| Provider Name | Taylor Autumn Andoe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528686151 PECOS PAC ID: 9234586629 Enrollment ID: I20231107000625 |
| Provider Name | Cathy Hodges |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346643681 PECOS PAC ID: 1153778519 Enrollment ID: I20231107003540 |
| Provider Name | Theo Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194369892 PECOS PAC ID: 4587011432 Enrollment ID: I20231114002747 |
| Provider Name | Alexis Moring |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1124695754 PECOS PAC ID: 1456708163 Enrollment ID: I20231116002076 |
| Provider Name | Deborah Frank |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659944635 PECOS PAC ID: 4789032400 Enrollment ID: I20231118000269 |
| Provider Name | John Vang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376046391 PECOS PAC ID: 5092163519 Enrollment ID: I20231122000663 |
| Provider Name | Summer Ann Warren |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598430431 PECOS PAC ID: 0941658017 Enrollment ID: I20231130000027 |
| Provider Name | Aaron Maytubby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326465030 PECOS PAC ID: 3678921780 Enrollment ID: I20231130001262 |
| Provider Name | Shavonne M Francis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760050249 PECOS PAC ID: 8426406448 Enrollment ID: I20231130001998 |
| Provider Name | Stephanie Adams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649725128 PECOS PAC ID: 2961850847 Enrollment ID: I20231204000736 |
| Provider Name | Charlie A Bell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083152110 PECOS PAC ID: 5698123578 Enrollment ID: I20231204000744 |
| Provider Name | Dustin Choate |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356680078 PECOS PAC ID: 2163870957 Enrollment ID: I20231205001630 |
| Provider Name | Jamie Cherie Thornton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588900492 PECOS PAC ID: 6305295098 Enrollment ID: I20231206002515 |
| Provider Name | Malena Blakley Munger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215316815 PECOS PAC ID: 0941659510 Enrollment ID: I20231207001871 |
| Provider Name | Jessica Richard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043330988 PECOS PAC ID: 1254780869 Enrollment ID: I20231207003447 |
| Provider Name | Kelly Smith Troutman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336260751 PECOS PAC ID: 6002265634 Enrollment ID: I20231207004203 |
| Provider Name | Victoria D Medlock |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689938342 PECOS PAC ID: 9931558400 Enrollment ID: I20231208001785 |
| Provider Name | Demi Shipley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427594886 PECOS PAC ID: 3779932108 Enrollment ID: I20231211003580 |
| Provider Name | Courtney S Anderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114435955 PECOS PAC ID: 8224487376 Enrollment ID: I20231214000898 |
| Provider Name | Whitney Gaddy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083004204 PECOS PAC ID: 6901256890 Enrollment ID: I20231218004368 |
| Provider Name | Chelsey Green |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548636368 PECOS PAC ID: 7810347721 Enrollment ID: I20231219000363 |
| Provider Name | Janette Nuspl |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164629093 PECOS PAC ID: 9436509023 Enrollment ID: I20231221004137 |
| Provider Name | Milynda Wade |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841852738 PECOS PAC ID: 4688024292 Enrollment ID: I20231222000969 |
| Provider Name | Robert Blasdel |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1124167960 PECOS PAC ID: 8325498959 Enrollment ID: I20231222001453 |
| Provider Name | Kristine Brinlee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184901159 PECOS PAC ID: 6800246125 Enrollment ID: I20231229000355 |
| Provider Name | Zachary Frische |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477187870 PECOS PAC ID: 5698125789 Enrollment ID: I20240102003100 |
| Provider Name | Monica Mccann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760830764 PECOS PAC ID: 6800246877 Enrollment ID: I20240103002489 |
| Provider Name | Diane B Hamilton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205056496 PECOS PAC ID: 7719338763 Enrollment ID: I20240104000569 |
| Provider Name | Kelly Bokay |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376614214 PECOS PAC ID: 2769724376 Enrollment ID: I20240104001808 |
| Provider Name | Michele Feathers-hefner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801206230 PECOS PAC ID: 5890146732 Enrollment ID: I20240104004285 |
| Provider Name | Larry Gantt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437433067 PECOS PAC ID: 5395196240 Enrollment ID: I20240104004483 |
| Provider Name | Ty Marie Wood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942443429 PECOS PAC ID: 6204287576 Enrollment ID: I20240111000277 |
| Provider Name | Guy Joseph Beauduy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053035014 PECOS PAC ID: 3173975216 Enrollment ID: I20240115000349 |
| Provider Name | Austin Peery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386018364 PECOS PAC ID: 5294188124 Enrollment ID: I20240126003989 |
| Provider Name | Ambra Gales |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437685377 PECOS PAC ID: 9638522279 Enrollment ID: I20240130002386 |
| Provider Name | John Klenke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043728793 PECOS PAC ID: 5294178927 Enrollment ID: I20240208004172 |
| Provider Name | Julia Debartolo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689100216 PECOS PAC ID: 3173967320 Enrollment ID: I20240215004140 |
| Provider Name | Ashley E Andrews |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073772752 PECOS PAC ID: 3870938368 Enrollment ID: I20240223001866 |
| Provider Name | Tressia Sue Hayes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598314965 PECOS PAC ID: 8022454149 Enrollment ID: I20240312002109 |
| Provider Name | Nicole Lawson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1790141422 PECOS PAC ID: 3577909563 Enrollment ID: I20240313000696 |
| Provider Name | Michele Keller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154747574 PECOS PAC ID: 7113364639 Enrollment ID: I20240320000879 |
| Provider Name | Billy Wideman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902271364 PECOS PAC ID: 7315384716 Enrollment ID: I20240321000275 |
| Provider Name | Tijuana Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467704445 PECOS PAC ID: 1850738089 Enrollment ID: I20240325000874 |
| Provider Name | Jackie Vo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174195622 PECOS PAC ID: 4082051115 Enrollment ID: I20240325001110 |
| Provider Name | Kim M Turner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952623183 PECOS PAC ID: 8123466091 Enrollment ID: I20240411000211 |
| Provider Name | Casey Raymond |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093386112 PECOS PAC ID: 2365882230 Enrollment ID: I20240426000166 |
| Provider Name | Shelley Waggoner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417299447 PECOS PAC ID: 8123468949 Enrollment ID: I20240426002186 |
| Provider Name | Toya Modeste |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932447000 PECOS PAC ID: 2365882800 Enrollment ID: I20240430004185 |
| Provider Name | Michelle Lancaster |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427359116 PECOS PAC ID: 4789025321 Enrollment ID: I20240514000173 |
| Provider Name | Carol Alexander |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578002457 PECOS PAC ID: 7810339629 Enrollment ID: I20240524001706 |
| Provider Name | Brianna Shamblin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336558618 PECOS PAC ID: 9335681428 Enrollment ID: I20240604003233 |
| Provider Name | Brianna Candida Minjares |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376216937 PECOS PAC ID: 0042752578 Enrollment ID: I20240611004504 |
| Provider Name | Susan Jablonski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770659369 PECOS PAC ID: 9931200193 Enrollment ID: I20240625000113 |
| Provider Name | Kristopher Don Cordero |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649664061 PECOS PAC ID: 5092258533 Enrollment ID: I20240625001445 |
| Provider Name | Yoonhee Kang |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1528540721 PECOS PAC ID: 1951844430 Enrollment ID: I20240625002742 |
| Provider Name | Sharon Kempen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346792546 PECOS PAC ID: 6002350337 Enrollment ID: I20240627003096 |
| Provider Name | Shelli Magin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992276034 PECOS PAC ID: 5991240129 Enrollment ID: I20240712000544 |
| Provider Name | Nickie Deann Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891147245 PECOS PAC ID: 2466997218 Enrollment ID: I20240716004095 |
| Provider Name | Jessica Libey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174122725 PECOS PAC ID: 9931645520 Enrollment ID: I20240718004341 |
| Provider Name | Keita Owens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851772123 PECOS PAC ID: 2769920180 Enrollment ID: I20240816001609 |
| Provider Name | Kellee D Shepherd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790264026 PECOS PAC ID: 7012455330 Enrollment ID: I20240819001407 |
| Provider Name | Allison Wallace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891460044 PECOS PAC ID: 8224576236 Enrollment ID: I20240821001033 |
| Provider Name | Matthew Dashner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295143063 PECOS PAC ID: 9234677295 Enrollment ID: I20240821003278 |
| Provider Name | Joshua Randal Steward |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1487296133 PECOS PAC ID: 2567901556 Enrollment ID: I20240821004959 |
| Provider Name | Leeann Lamb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194393579 PECOS PAC ID: 7618416504 Enrollment ID: I20240822003812 |
| Provider Name | Adam Daniel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992374920 PECOS PAC ID: 9739628595 Enrollment ID: I20240826001797 |
| Provider Name | Cayla Checorski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336630540 PECOS PAC ID: 0143769810 Enrollment ID: I20240826002452 |
| Provider Name | Melinda Rivera |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1659823862 PECOS PAC ID: 5193264810 Enrollment ID: I20240827000160 |
| Provider Name | Jessica Rhea Steelman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710243829 PECOS PAC ID: 9537608252 Enrollment ID: I20240827000191 |
| Provider Name | Hannah Anderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518467950 PECOS PAC ID: 0840739421 Enrollment ID: I20240827003101 |
| Provider Name | John E Offutt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184169385 PECOS PAC ID: 2567901184 Enrollment ID: I20240827004637 |
| Provider Name | Nicole Mouton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659795086 PECOS PAC ID: 6608315148 Enrollment ID: I20240828000878 |
| Provider Name | Harve Leroy Dorman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932243185 PECOS PAC ID: 8224577663 Enrollment ID: I20240828005196 |
| Provider Name | Stephanie Redding |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1124230206 PECOS PAC ID: 6608315080 Enrollment ID: I20240829001298 |
| Provider Name | Garland Brinlee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164997052 PECOS PAC ID: 6709325194 Enrollment ID: I20240829001681 |
| Provider Name | Desiree R Heskett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528267846 PECOS PAC ID: 1052850393 Enrollment ID: I20240829003822 |
| Provider Name | Alexandre Goncalves |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871884536 PECOS PAC ID: 6709325830 Enrollment ID: I20240903002353 |
| Provider Name | Marilyn Guhl |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619993516 PECOS PAC ID: 5092255182 Enrollment ID: I20240904000742 |
| Provider Name | Deanna Ukena |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578714119 PECOS PAC ID: 8820538929 Enrollment ID: I20240904001143 |
| Provider Name | Ashley Rogers-edmonds |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093288656 PECOS PAC ID: 9830639996 Enrollment ID: I20240904003560 |
| Provider Name | Erin Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447704044 PECOS PAC ID: 6002356185 Enrollment ID: I20240904004547 |
| Provider Name | Tamara Defranc |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104106749 PECOS PAC ID: 1355881343 Enrollment ID: I20240905000042 |
| Provider Name | Jason Zwink |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427247006 PECOS PAC ID: 9537609409 Enrollment ID: I20240905003452 |
| Provider Name | Esther Adedayo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558989897 PECOS PAC ID: 9234679143 Enrollment ID: I20240906000380 |
| Provider Name | Matt Youngberg |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437407947 PECOS PAC ID: 4385184217 Enrollment ID: I20240906000987 |
| Provider Name | Jada Shanel Alexander |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588908966 PECOS PAC ID: 5698215549 Enrollment ID: I20240906001749 |
| Provider Name | Kelli Muse |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154876803 PECOS PAC ID: 7911447776 Enrollment ID: I20240906002705 |
| Provider Name | Heather Rose |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508498726 PECOS PAC ID: 0547700312 Enrollment ID: I20240906002805 |
| Provider Name | Dawn Colbert-dixon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386193167 PECOS PAC ID: 9032659818 Enrollment ID: I20240906003574 |
| Provider Name | Mary E Summers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841623444 PECOS PAC ID: 5991245730 Enrollment ID: I20240909000844 |
| Provider Name | Zachary Love |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1770837478 PECOS PAC ID: 7517407273 Enrollment ID: I20240909001814 |
| Provider Name | Kara Jamison |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093242539 PECOS PAC ID: 5395285936 Enrollment ID: I20240910000788 |
| Provider Name | James Garner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124663224 PECOS PAC ID: 8325588973 Enrollment ID: I20240910001022 |
| Provider Name | Ashley Briggs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396328324 PECOS PAC ID: 7517407042 Enrollment ID: I20240910004354 |
| Provider Name | Darrin Doyl Mcdaniel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831400019 PECOS PAC ID: 1254871791 Enrollment ID: I20240910004739 |
| Provider Name | Kassidee G Mcginnis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700556552 PECOS PAC ID: 4789124231 Enrollment ID: I20240911000175 |
| Provider Name | Kirsten Rose Fraizer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083261739 PECOS PAC ID: 6507306917 Enrollment ID: I20240912001438 |
| Provider Name | Garrison Gold |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386241644 PECOS PAC ID: 5597205872 Enrollment ID: I20240912004519 |
| Provider Name | Debra Louise Wright-burns |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427336072 PECOS PAC ID: 3274073556 Enrollment ID: I20240913000084 |
| Provider Name | Wendy Bohorquez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124796347 PECOS PAC ID: 7719427905 Enrollment ID: I20240914000752 |
| Provider Name | Jace Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083382451 PECOS PAC ID: 4587105739 Enrollment ID: I20240916002207 |
| Provider Name | Erika Engelman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578946554 PECOS PAC ID: 5193116507 Enrollment ID: I20240917003903 |
| Provider Name | Austin Chad Sheppard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790447092 PECOS PAC ID: 6901347806 Enrollment ID: I20240918004709 |
| Provider Name | Melissa Dawn Crawford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205355609 PECOS PAC ID: 5496296287 Enrollment ID: I20240919003797 |
| Provider Name | Sandra Wright |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194925974 PECOS PAC ID: 9739620253 Enrollment ID: I20240924001093 |
| Provider Name | Jeffrey David Rothman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063874030 PECOS PAC ID: 0042751539 Enrollment ID: I20240924003740 |
| Provider Name | John Allen Haile |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528343563 PECOS PAC ID: 2860933215 Enrollment ID: I20240925002130 |
| Provider Name | Shemaiah Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619448263 PECOS PAC ID: 4385185776 Enrollment ID: I20240925003565 |
| Provider Name | Virginia Elizabeth Geary |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003330747 PECOS PAC ID: 7012458383 Enrollment ID: I20240926001964 |
| Provider Name | Lorrene Shelton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972030476 PECOS PAC ID: 5092246397 Enrollment ID: I20240926003436 |
| Provider Name | Haley Nunn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720239676 PECOS PAC ID: 8325579634 Enrollment ID: I20240926004041 |
| Provider Name | Brianna Elaina Bloom |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619647427 PECOS PAC ID: 5799216982 Enrollment ID: I20240927003190 |
| Provider Name | Mona Gay Brenneman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669506416 PECOS PAC ID: 7214468412 Enrollment ID: I20240929000091 |
| Provider Name | Yalonda Berry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154666485 PECOS PAC ID: 0749711679 Enrollment ID: I20241003000326 |
| Provider Name | Alishia Butler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396263810 PECOS PAC ID: 1052842879 Enrollment ID: I20241003004176 |
| Provider Name | Jacen Byrd |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871081935 PECOS PAC ID: 6800328246 Enrollment ID: I20241010001395 |
| Provider Name | Ashley Slead |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366851594 PECOS PAC ID: 1951833284 Enrollment ID: I20241011001793 |
| Provider Name | Devin Watson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881184802 PECOS PAC ID: 5294267266 Enrollment ID: I20241015003207 |
| Provider Name | Kimberely Strickland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801542360 PECOS PAC ID: 1153853809 Enrollment ID: I20241018001661 |
| Provider Name | Patty Jill Hakel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578860243 PECOS PAC ID: 3072046408 Enrollment ID: I20241024000204 |
| Provider Name | David Porter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376096990 PECOS PAC ID: 5496288540 Enrollment ID: I20241028001708 |
| Provider Name | Brenda Kay Lee Stoops |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124019708 PECOS PAC ID: 5395270003 Enrollment ID: I20241118004186 |
| Provider Name | Melissa Mae Lile |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215296736 PECOS PAC ID: 7012442502 Enrollment ID: I20241120003248 |
| Provider Name | Linda Danks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255810354 PECOS PAC ID: 4880129246 Enrollment ID: I20241121001973 |
| Provider Name | Megan Cizerle-brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174952956 PECOS PAC ID: 7416482674 Enrollment ID: I20241125001687 |
| Provider Name | Melissa Pipestem |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346932878 PECOS PAC ID: 6507391711 Enrollment ID: I20241125003635 |
| Provider Name | Christian Peters |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932795085 PECOS PAC ID: 0840726147 Enrollment ID: I20241210003419 |
| Provider Name | Jessica Mcchesney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689257859 PECOS PAC ID: 6103352349 Enrollment ID: I20241211000661 |
| Provider Name | Brenda Bennett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841496031 PECOS PAC ID: 9739615790 Enrollment ID: I20241213001383 |
Rocmnd Area Youth Services Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 33 N Main St Ste 8, Miami, OK 74354 Phone: 918-540-1563 Fax: 918-542-7778 | |
Nova Therapy Works, P.l.l.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 207 2nd Ave Sw, Miami, OK 74354 Phone: 918-540-7458 Fax: 918-540-7455 | |
Meta Mental Health Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 218 E Central Ave Ste A, Miami, OK 74354 Phone: 918-919-3298 | |