| Poyner Mental Health Services | |
|
14453 Se 29th St Ste D Choctaw OK 73020-6543 | |
| (405) 741-2844 | |
| (405) 733-1334 |
| Full Name | Poyner Mental Health Services |
|---|---|
| Speciality | Counselor |
| Location | 14453 Se 29th St Ste D, Choctaw, Oklahoma |
| Authorized Official Name and Position | Kimberly Nicole Woodhouse (OWNER) |
| Authorized Official Contact | 4057412844 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Poyner Mental Health Services 14453 Se 29th St Ste D Choctaw OK 73020-6543 Ph: (405) 741-2844 | Poyner Mental Health Services 14453 Se 29th St Ste D Choctaw OK 73020-6543 Ph: (405) 741-2844 |
| NPI Number | 1740845361 |
|---|---|
| Provider Enumeration Date | 05/08/2019 |
| Last Update Date | 05/08/2019 |
| Medicare PECOS PAC ID | 1153779145 |
|---|---|
| Medicare Enrollment ID | O20231201001081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740845361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Toni A Foster |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942594999 PECOS PAC ID: 7214386085 Enrollment ID: I20231206001116 |
| Provider Name | Helen Marie Allred |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508189465 PECOS PAC ID: 4284086877 Enrollment ID: I20240118004709 |
| Provider Name | Kimberly Woodhouse |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114427267 PECOS PAC ID: 2062860059 Enrollment ID: I20240220000201 |
| Provider Name | Jennifer Conner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043437163 PECOS PAC ID: 8224476866 Enrollment ID: I20240402002773 |
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