| Moore Counseling Center, P.c. | |
|
604 S Classen Ave Ste A Moore OK 73160-5401 | |
| (405) 735-6333 | |
| (405) 735-6629 |
| Full Name | Moore Counseling Center, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 604 S Classen Ave, Moore, Oklahoma |
| Authorized Official Name and Position | Dustin Gant Ward (DIRECTOR) |
| Authorized Official Contact | 4057356333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moore Counseling Center, P.c. 604 S Classen Ave Ste A Moore OK 73160-5401 Ph: (405) 735-6333 | Moore Counseling Center, P.c. 604 S Classen Ave Ste A Moore OK 73160-5401 Ph: (405) 735-6333 |
| NPI Number | 1427140219 |
|---|---|
| Provider Enumeration Date | 09/29/2006 |
| Last Update Date | 01/14/2008 |
| Medicare PECOS PAC ID | 9436151511 |
|---|---|
| Medicare Enrollment ID | O20070201000506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427140219 | NPI | - | NPPES |
| Provider Name | Dustin Gant Ward |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922048479 PECOS PAC ID: 1658388525 Enrollment ID: I20060329000553 |
| Provider Name | Rachel B Smiley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104132141 PECOS PAC ID: 4880843374 Enrollment ID: I20120926000673 |
| Provider Name | Kimi L Carson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518925262 PECOS PAC ID: 3072565332 Enrollment ID: I20170223002175 |
| Provider Name | Dave S Kerby |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114463072 PECOS PAC ID: 5294019972 Enrollment ID: I20170223002247 |
| Provider Name | Justin H Ory |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124426671 PECOS PAC ID: 0648508358 Enrollment ID: I20190820000135 |
| Provider Name | Virginia Burk |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629587118 PECOS PAC ID: 0648609149 Enrollment ID: I20200404000088 |
| Provider Name | Alicia L Venus |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144603945 PECOS PAC ID: 8123381928 Enrollment ID: I20230531001856 |
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