Northcare | |
2617 General Pershing Blvd Oklahoma City OK 73107-6437 | |
(405) 858-1700 | |
(405) 858-2810 |
Full Name | Northcare |
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Speciality | Counselor |
Location | 2617 General Pershing Blvd, Oklahoma City, Oklahoma |
Authorized Official Name and Position | Lonnie Rice (CFO) |
Authorized Official Contact | 4058582735 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Northcare Po Box 12978 Oklahoma City OK 73157-2978 Ph: (405) 858-2700 | Northcare 2617 General Pershing Blvd Oklahoma City OK 73107-6437 Ph: (405) 858-1700 |
NPI Number | 1821120189 |
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Provider Enumeration Date | 03/12/2007 |
Last Update Date | 04/15/2024 |
Certification Date | 04/15/2024 |
Medicare PECOS PAC ID | 6002701786 |
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Medicare Enrollment ID | O20040220000470 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821120189 | NPI | - | NPPES |
100735340F | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Rajeswara Bhupathiraju |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1578599916 PECOS PAC ID: 8628966793 Enrollment ID: I20040310001011 |
Provider Name | Sue C Rollins |
---|---|
Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1528104684 PECOS PAC ID: 1254418080 Enrollment ID: I20080404000001 |
Provider Name | Ahsan Y Khan |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1346245479 PECOS PAC ID: 4082640354 Enrollment ID: I20111102000303 |
Provider Name | Agata K Karch |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1952555344 PECOS PAC ID: 8628228491 Enrollment ID: I20121101000585 |
Provider Name | Sandra Taber |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1184766511 PECOS PAC ID: 6002043940 Enrollment ID: I20131220000606 |
Provider Name | Brandie A Strange |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699102616 PECOS PAC ID: 2769612647 Enrollment ID: I20141027001210 |
Provider Name | Rachel J Picon |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1346557865 PECOS PAC ID: 3870819584 Enrollment ID: I20150223001793 |
Provider Name | Josephine Deguzman |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1043391675 PECOS PAC ID: 0143509455 Enrollment ID: I20161109000882 |
Provider Name | Peter Craig Kowalski |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1639107444 PECOS PAC ID: 4880839208 Enrollment ID: I20180928001550 |
Provider Name | Sophia Renee Nieto |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1659710325 PECOS PAC ID: 4981945458 Enrollment ID: I20190410000864 |
Provider Name | Darlene Rose Cook |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1548479025 PECOS PAC ID: 0446591820 Enrollment ID: I20190411002815 |
Provider Name | Kathryn Marie Shelton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164996641 PECOS PAC ID: 0840531901 Enrollment ID: I20190418000670 |
Provider Name | Mary Margaret Mcmiller |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1194108746 PECOS PAC ID: 9133457849 Enrollment ID: I20190820000392 |
Provider Name | Kelsey Ann Wilson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033619465 PECOS PAC ID: 5698160372 Enrollment ID: I20220315002868 |
Provider Name | Jessica Anne Stevens |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1356846133 PECOS PAC ID: 8123473568 Enrollment ID: I20231004003991 |
Provider Name | Margaret Call |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1124794516 PECOS PAC ID: 9133571722 Enrollment ID: I20240119000126 |
Provider Name | Tara Linden Gamsjager |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1205054707 PECOS PAC ID: 1052754827 Enrollment ID: I20240208002027 |
Provider Name | Jeffery David Bishop |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1275171076 PECOS PAC ID: 8921441619 Enrollment ID: I20240209001418 |
Provider Name | Garrett Thomas Gilmore |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1326624453 PECOS PAC ID: 3870937998 Enrollment ID: I20240216002403 |
Provider Name | Vanessa Fortune |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1225417165 PECOS PAC ID: 1557706827 Enrollment ID: I20240226003573 |
Provider Name | Lacinda Shae Daugherty |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1366646523 PECOS PAC ID: 9537504543 Enrollment ID: I20240229002827 |
Provider Name | Robin Lee Moore |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1881803526 PECOS PAC ID: 3870930019 Enrollment ID: I20240322002390 |
Provider Name | Christopher Gordon Geis |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1497209886 PECOS PAC ID: 3072951714 Enrollment ID: I20240401002423 |
Provider Name | Karli Nicole Mcfarland |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1801402334 PECOS PAC ID: 2961840483 Enrollment ID: I20240403002216 |
Provider Name | Stephanie Carey |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1588096564 PECOS PAC ID: 4082053137 Enrollment ID: I20240422002836 |
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