RANDY MARC STINE (NPI# 1154585917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154585917 |
| Entity Type | Individual |
| Full Name | RANDY MARC STINE |
| Credential | BS, CADC, ADSAC |
| Practice Address |
32300 S 625 Rd Grove OK 74345-1585 |
| Mailing Address |
4602 Us Highway 59 N Grove OK 74344-4229 |
| Practice Telephone | 9187872242 |
| Practice Fax Number | 9187865985 |
| Mailing Telephone | 9187872242 |
| Mailing Fax Number | 9187865985 |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2016-03-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
32300 S 625 RD |
| City | GROVE |
| State | OK |
| Zip Code | 74345-1585 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477763811 | George R Pilkinton | Counselor | 32300 S 625 Rd, Grove, OK 74345-1585 | 2007-05-23 |
| 1174182232 | Jeffery Alan Forbes | Peer Specialist | 32300 S 625 Rd, Grove, OK 74344-6285 | 2019-06-11 |
| 1750820569 | Bryan Russell | Peer Specialist | 32300 S 625 Rd, Grove, OK 74344-6285 | 2017-02-14 |
| 1780063388 | Benjamin Dodson | Counselor | 32300 S 625 Rd, Grove, OK 74344-6285 | 2015-05-28 |
| 1265821102 | Jimmy Selanders Jr. | Clinic/Center | 32300 S 625 Rd, Grove, OK 74344-6285 | 2015-01-15 |
| 1942576186 | Michael R Doyle | Counselor | 32300 S 625 Rd, Grove, OK 74344-6285 | 2012-03-31 |
| 1275848384 | House of Hope Inc | Substance Abuse Rehabilitation Facility | 32300 S 625 Rd, Grove, OK 74345-1585 | 2010-08-12 |
| 1366606089 | Duke Leroy Spurgeon | Counselor | 32300 S 625 Rd, Grove, OK 74345-1585 | 2008-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053645143 | Lesa Anne Landon | Licensed Practical Nurse | 63153 East 290 Road, Grove, OK 74345 | 2009-09-23 |
| 1619037678 | Sandra Petrick | Psychologist | 209 East 6 Street, Grove, OK 74345 | 2006-12-11 |
| 1366822959 | Denise Durbin | Speech-Language Pathologist | 700 West 7th Street, Grove, OK 74345 | 2015-06-09 |
| 1154628790 | Oak Lake, LLC | Skilled Nursing Facility | 103 Har-ber Rd, Grove, OK 74345-0547 | 2011-02-17 |
| 1205216272 | Rebecca Malinda Earp | Psychologist | 700 West 7th Street, Grove, OK 74345-0789 | 2015-06-04 |
| 1578511440 | Brett Cole | Counselor | 1115 W. Har-ber Road, Grove, OK 74345-1385 | 2006-05-04 |
| 1962554089 | Sara C Pennell | Chiropractor | 901 S Main, Grove, OK 74345-3064 | 2007-01-17 |
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174046841 | Rachel Artura Mikes | Counselor | 818 Apple Dr, Grove, OK 74344-3808 | 2017-07-25 |
| 1548469448 | Larry Eugene Smith Sr. | Counselor | 32208 S. 620 Rd, Grove, OK 74344 | 2007-07-12 |
| 1467650010 | Karl Napier | Counselor | 32208 South 620 Road, Grove, OK 74344 | 2007-07-05 |
| 1477763811 | George R Pilkinton | Counselor | 32300 S 625 Rd, Grove, OK 74345-1585 | 2007-05-23 |
| 1780063388 | Benjamin Dodson | Counselor | 32300 S 625 Rd, Grove, OK 74344-6285 | 2015-05-28 |
| 1942576186 | Michael R Doyle | Counselor | 32300 S 625 Rd, Grove, OK 74344-6285 | 2012-03-31 |
| 1194032805 | Yco, Inc | Counselor | 1107 E 13th St, Grove, OK 74344-7955 | 2010-09-02 |
| 1346555463 | Mark B Westfall | Counselor | 1115 Harber Rd., Grove, OK 74344 | 2010-08-12 |
| 1366606089 | Duke Leroy Spurgeon | Counselor | 32300 S 625 Rd, Grove, OK 74345-1585 | 2008-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295341337 | Juan Miguel Jimenez | Counselor | 713 Nw 139th St, Edmond, OK 73013-1912 | 2020-09-22 |
| 1790396042 | Amazing Life Behavioral Health and Addiction Services | Counselor | 324 N 19th St Ste 101, Guthrie, OK 73044-2117 | 2020-08-11 |
| 1144839994 | Jill Brittny Johnson | Counselor | 2840 Nw 31st St, Oklahoma City, OK 73112-7407 | 2020-07-28 |
| 1417565243 | Angela Darlene Brooks | Counselor | 3605 Ne 142nd Ct, Edmond, OK 73013-7224 | 2020-07-17 |
| 1285252304 | Max Anna Hanna | Counselor | 2600 W. Coffee Creek Rd, Edmond, OK 73025 | 2020-07-07 |
| 1366060444 | John Christopher Lewis | Counselor | 6302 N Garrison Ave, Tulsa, OK 74126-1512 | 2020-07-06 |
| 1710502505 | Sally Smith | Counselor | 4525 Southcreek Rd, Moore, OK 73165-7359 | 2020-06-08 |
| 1487273223 | Maxwell Brown Enterprise, LLC | Counselor | 250 E Apache St, Tulsa, OK 74106-3702 | 2020-04-12 |
| 1679105068 | Audrey June Halfacre | Counselor | 4803 Ridge St, Tahlequah, OK 74464-5644 | 2020-02-04 |
| 1760021984 | Damilola Mosebolatan Akintola | Counselor | 5013 Oak Manor Dr, Oklahoma City, OK 73135-2235 | 2020-01-06 |
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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.