KICKAPOO BEHAVIORAL HEALTH (NPI# 1063607117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063607117 |
| Entity Type | Organization |
| Organization Name | KICKAPOO BEHAVIORAL HEALTH |
| Practice Address |
404 North Highway 102 Mcloud OK 74851 |
| Mailing Address |
407 North Highway 102 Mcloud OK 74851 |
| Practice Telephone | 4059642081 |
| Practice Fax Number | 4059645677 |
| Mailing Telephone | 4059642081 |
| Mailing Fax Number | 4059645677 |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MS. WILLA DEAN CROW (SUBSTANCE ABUSE COUNSELOR) |
| Authorized Official Telephone | 4059642081 |
| Authorized Official Credential | CADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
98 | OK | Ambulatory Health Care Facilities |
| Street Address |
404 NORTH HIGHWAY 102 |
| City | MCLOUD |
| State | OK |
| Zip Code | 74851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770039489 | Victoria Morris | Counselor | 13251 S. Mcloud Rd., Mcloud, OK 74851 | 2016-09-01 |
| 1922417674 | Brenda Davis | Registered Nurse | 105365 South Hwy 102, Mcloud, OK 74851 | 2014-08-07 |
| 1710390323 | Mcloud Dental Center P.l.l.c. | Dentist | 806 South 8th Street, Mcloud, OK 74851 | 2014-06-11 |
| 1508116542 | Kathryn Dean Jones | Pharmacist | 105365 South Highway 102, Mcloud, OK 74851 | 2012-09-18 |
| 1407128572 | Kickapoo Health Center | Counselor | 105365 S.highway 102, Mcloud, OK 74851 | 2012-02-03 |
| 1326349549 | Lisa A Lauderdale | Pharmacist | 409 North Hwy 102, Mcloud, OK 74851 | 2010-11-04 |
| 1265733539 | Mark I Gomez | Counselor | 105365 Highway102, Mcloud, OK 74851 | 2010-11-03 |
| 1396055679 | Cynthia Seger | Dietitian, Registered | 407 N. Highway 102, Mcloud, OK 74851 | 2010-10-20 |
| 1649595869 | Keith Allen Mehner | Dentist | 403 West Broadway Avenue, Mcloud, OK 74851 | 2010-03-30 |
| 1326203480 | Tyler Wellhausen | Pharmacist | 409 N Hwy 102, Mcloud, OK 74851 | 2008-07-28 |
| Find all providers in zip 74851 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649460650 | Payne County Drug Court, Inc. | Clinic/Center | 217 W 5th Ave, Suite 7, Stillwater, OK 74074-4056 | 2007-07-26 |
| 1174739130 | Community Action Agency Turning Point | Clinic/Center | 1607 Sw 15th St, Oklahoma City, OK 73108-6803 | 2007-05-15 |
| 1528122355 | Arbuckle Life Solutions, Inc. | Clinic/Center | 9 10th Ave Nw, Ardmore, OK 73401-5929 | 2006-12-19 |
| 1144331802 | Gateway To Prevention and Recovery, Inc. | Clinic/Center | 1010 E 45th St, Shawnee, OK 74804-2202 | 2006-08-31 |
| 1801826706 | Valley Hope Association | Clinic/Center | 1422 E 71 St, Ste F, Tulsa, OK 74136-5060 | 2006-07-04 |
| 1184654089 | Valley Hope Association | Clinic/Center | 6110 Nw 63rd St, Oklahoma City, OK 73132-7526 | 2006-07-04 |
| 1437198843 | United Community Action Program, Inc. | Clinic/Center | 600 Denver St, Pawnee, OK 74058-3522 | 2006-06-05 |
| 1649737990 | Compass Clinic | Clinic/Center | 701 Ne 36th St, Oklahoma City, OK 73105-7203 | 2019-02-22 |
| 1699016899 | The Center for Therapeutic Interventions | Clinic/Center | 4100 Se Adams Rd, Bartlesville, OK 74006-8437 | 2013-03-13 |
Please comment or provide details below to improve the information on KICKAPOO BEHAVIORAL HEALTH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.