OKLAHOMA CLINICAL MANAGEMENT LLC (NPI# 1073001756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073001756 |
| Entity Type | Organization |
| Organization Name | OKLAHOMA CLINICAL MANAGEMENT LLC |
| Practice Address |
4301 Nw 63rd St Ste 107 Oklahoma City OK 73116 |
| Mailing Address |
4301 Nw 63rd St Ste 107 Oklahoma City OK 73116-1548 |
| Practice Telephone | 4055930583 |
| Mailing Telephone | 4055930583 |
| Mailing Fax Number | 4052765703 |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2020-03-09 |
| Authorized Official Name | JEANETTE MCCOLLOM (OWNER/CO-FOUNDER) |
| Authorized Official Telephone | 4055134522 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 405300000X | Prevention Professional | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1302 W Missouri Ave, Chickasha, OK 73018 | 4055134522 | |
| 928 S 16th St, Chickasha, OK 730183941 | 4055134522 |
| Street Address |
4301 NW 63RD ST STE 107 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801358791 | Arkansas Clinical Management, LLC | Prevention Professional | 4301 Nw 63rd St Ste 107, Corporate Office, Oklahoma City, OK 73116-1548 | 2019-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306455068 | Restore Family Counseling, LLC | Clinic/Center | 100 W. Wilshire, Suite #c3, Oklahoma City, OK 73116 | 2020-07-29 |
| 1861058877 | Dental Depot of 63rd & Nw Expressway, Pllc | Clinic/Center | 4025 Nw 63rd Street, Oklahoma City, OK 73116 | 2019-05-15 |
| 1235658261 | Heinen Physical Therapy, PC | Clinic/Center | 7710 N May Ave, Oklahoma City, OK 73116 | 2017-09-11 |
| 1235657842 | Jacque S Komers | Counselor | 6501 N Broadway Ext Suite 180, Oklahoma City, OK 73116 | 2017-09-04 |
| 1164943874 | Jo Ann Cole-johnson | Counselor | 6505 N. Shawnee Ave, Oklahoma, OK 73116 | 2017-07-03 |
| 1548790793 | Zachary Wayne Skates | Case Manager/Care Coordinator | North 6501 Broadway Extention Highway #180, Oklahoma City, OK 73116 | 2017-06-19 |
| 1548622673 | Jessica Defiore | Case Manager/Care Coordinator | 6501 N Broadway Extension, Oklahoma City, OK 73116 | 2016-03-28 |
| 1093173247 | Patrice Ann Cook | Specialist/Technologist, Other | 7700 N. Hudson Ave, Suite Number 9, Oklahoma City, OK 73116 | 2016-02-03 |
| 1467880708 | Abrina Marie Kneeland | Occupational Therapy Assistant | 6525 N. Meridian #311, Therapists Unlimited Division of Career Staff, Oklahoma City, OK 73116 | 2013-10-24 |
| 1538591649 | Lauren Collier Peterson | Physical Therapist | 7415 N May Ave, Oklahoma City, OK 73116 | 2013-07-31 |
| Find all providers in zip 73116 | ||||
| Taxonomy Code | 405300000X |
| Grouping | Other Service Providers |
| Classification | Prevention Professional |
| Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801358791 | Arkansas Clinical Management, LLC | Prevention Professional | 4301 Nw 63rd St Ste 107, Corporate Office, Oklahoma City, OK 73116-1548 | 2019-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649703349 | Erica Porter | Prevention Professional | 4760 E 68th St, #267, Tulsa, OK 74136 | 2017-04-10 |
| 1356889745 | Brenda Stacy | Prevention Professional | 507 Drwey, Potesu, OK 74953 | 2017-02-06 |
| 1336610708 | Nancy Lanette Cavner | Prevention Professional | 1011 14th Ave Nw, Ardmore, OK 73401-1828 | 2018-12-11 |
| 1689107070 | Sprouts Child Development Initiative, Inc. | Prevention Professional | 5840 S Memorial Dr Ste 111, Tulsa, OK 74145-9006 | 2017-04-04 |
| City | OKLAHOMA CITY |
| Zip Code | 73116 |
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| 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.