IRIDIA CHAVEZ MARES (NPI# 1114538477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114538477 |
| Entity Type | Individual |
| Full Name | IRIDIA CHAVEZ MARES |
| Practice Address |
2617 General Pershing Blvd Oklahoma City OK 73107-6437 |
| Mailing Address |
Po Box 12978 Oklahoma City OK 73157-2978 |
| Practice Telephone | 4058581700 |
| Mailing Telephone | 4058581700 |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2020-08-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
2617 GENERAL PERSHING BLVD |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73107-6437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346245479 | Ahsan Y Khan | Psychiatry & Neurology | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2005-06-16 |
| 1801402334 | Karli Nicole Smith | Counselor | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-09-21 |
| 1306459193 | Kristen Dunham | Counselor | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-08-31 |
| 1043823206 | Cammie Lorraine Soriano | Case Manager/Care Coordinator | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-08-27 |
| 1386257673 | Abigail Kirsten Williams | Case Manager/Care Coordinator | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-08-26 |
| 1962014258 | Brandi Shearer | Counselor | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-08-19 |
| 1457961542 | Tiffany Jeanette Lefebvre | Peer Specialist | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-08-04 |
| 1790393262 | Amy Pavelka | Case Manager/Care Coordinator | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-07-21 |
| 1386262632 | Riley Jordan Copeland | Counselor | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-07-13 |
| 1174147177 | Lydia Haugh | Case Manager/Care Coordinator | 2617 General Pershing Blvd, Oklahoma City, OK 73107-6437 | 2020-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144747999 | Ellen Rose Pochyly | Counselor | 2617 General Pershing Boulevard, Oklahoma City, OK 73107 | 2017-08-23 |
| 1609399906 | Carrie Ann Moore | Counselor | 2617 General Pershing Blvd., Oklahoma City, OK 73107 | 2017-07-19 |
| 1821511320 | Diana Lynn Spencer | Counselor | 2617generalpershingblvd, Oklahoma City, OK 73107 | 2017-07-18 |
| 1861859514 | Catherine Evans | Counselor | 500 N Meridian Ave Ste 409, Oklahoma City, OK 73107 | 2016-01-26 |
| 1871964551 | Kizzy Frazier | Student in an Organized Health Care Education/Training Program | 1233 N Warren Pl, Oklahoma City, OK 73107 | 2015-10-07 |
| 1538550629 | Oklahoma Department of Mental Health and Substance Abuse | Case Management | 2625 General Pershing Boulevard, Oklahoma City, OK 73107 | 2015-02-10 |
| 1952702276 | Andale Healthcare, LLC | Clinic/Center | 2305 N. Meridian, Oklahoma City, OK 73107 | 2014-09-05 |
| 1114339348 | John Walls | Psychologist | 2012 North Villa Avenue, Oklahoma City, OK 73107 | 2014-05-22 |
| 1376970517 | Latrice Warrior | Community/Behavioral Health | 2625 General Pershing Drive, Oklahoma City, OK 73107 | 2013-10-02 |
| 1326485541 | Debra Sue Vaughan | Counselor | 2617 Genral Pershing Blvd, Oklahoma City, OK 73107 | 2013-05-29 |
| Find all providers in zip 73107 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861002818 | Keegan Eisenhardt | Peer Specialist | 6405 S Villa Ave, Oklahoma City, OK 73159-2741 | 2020-08-05 |
| 1689283780 | Gregory Purvis Jr. | Peer Specialist | 1305 Parkwoods Ct, Oklahoma City, OK 73110-7425 | 2020-07-24 |
| 1609485762 | Amanda Elaine Cruz | Peer Specialist | 1605 Nw 30th St Apt 228, Oklahoma City, OK 73118-3622 | 2020-07-24 |
| 1063021384 | Christina Len Petty | Peer Specialist | 2144 Nw 29th St, Oklahoma City, OK 73107-2526 | 2020-07-23 |
| 1104443977 | Jennifer Lynn Cobb | Peer Specialist | 2400 General Pershing Blvd Apt 308, Oklahoma City, OK 73107-6429 | 2020-06-28 |
| 1801412135 | Cleborn Gossett | Peer Specialist | 721 Waterview Rd, Oklahoma City, OK 73170-1637 | 2020-06-23 |
| 1487270617 | Foxy S Starnes | Peer Specialist | 9008 N Shannon Ave, Oklahoma City, OK 73132-1142 | 2020-06-23 |
| 1154945582 | Alexandra Paige Mcgowan-rayburn | Peer Specialist | 4129 Nw 21st St, Oklahoma City, OK 73107-2607 | 2020-06-01 |
| 1962034504 | Crystal Rose Mckee | Peer Specialist | 3417 S Independence Ave, Oklahoma City, OK 73119-2617 | 2020-02-11 |
| 1508496662 | Brie Jordan Florence | Peer Specialist | 2640 Sw 95th St, Oklahoma City, OK 73159-6720 | 2020-01-16 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73107 |
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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.