Red Dirt Mental Health, Inc. | |
4330 Adams Rd Ste 100 Norman OK 73069-1007 | |
(405) 704-8400 | |
(405) 253-0490 |
Full Name | Red Dirt Mental Health, Inc. |
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Speciality | Psychologist |
Location | 4330 Adams Rd Ste 100, Norman, Oklahoma |
Authorized Official Name and Position | Jenny Bendure (HEALTH SERVICE PSYCHOLOGIST) |
Authorized Official Contact | 4053709614 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Red Dirt Mental Health, Inc. 4330 Adams Rd Ste 100 Norman OK 73069-1007 Ph: (405) 704-8400 | Red Dirt Mental Health, Inc. 4330 Adams Rd Ste 100 Norman OK 73069-1007 Ph: (405) 704-8400 |
NPI Number | 1235672692 |
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Provider Enumeration Date | 12/02/2016 |
Last Update Date | 03/27/2024 |
Certification Date | 03/27/2024 |
Medicare PECOS PAC ID | 5294017901 |
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Medicare Enrollment ID | O20170112002089 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235672692 | NPI | - | NPPES |
200677510A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
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103T00000X | Psychologist | 1250 (Oklahoma) | Primary |
Provider Name | Jenny M Bendure |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1013398668 PECOS PAC ID: 7618272980 Enrollment ID: I20160224001335 |
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