MICHAEL KEITH BURNSIDE (NPI# 1194739334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194739334 |
| Entity Type | Individual |
| Full Name | MICHAEL KEITH BURNSIDE |
| Credential | LPC, LADC |
| Practice Address |
100 W 7th St Ste 102 Okmulgee OK 74447-5007 |
| Mailing Address |
720 S 5th St Morris OK 74445-2224 |
| Practice Telephone | 9187581910 |
| Practice Fax Number | 9187561270 |
| Mailing Telephone | 9187334603 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2009-03-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
553 | OK | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
2650 | OK | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | MEDICARE | 300522336 | 01 |
| Street Address |
100 W 7TH ST STE 102 |
| City | OKMULGEE |
| State | OK |
| Zip Code | 74447-5007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023244944 | Thomasine L. Fife | Counselor | 100 W 7th St Ste 102, Okmulgee, OK 74447-5007 | 2009-06-05 |
| 1427283142 | Miranda Carman | Social Worker | 100 W 7th St Ste 102, Okmulgee, OK 74447-5007 | 2009-05-26 |
| 1083724074 | Bruce R Hodson | Psychologist | 100 W 7th St Ste 102, Okmulgee, OK 74447-5007 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932718376 | David Louis Holden | Counselor | 1803 W Wood Drive, Okmulgee, OK 74447 | 2020-07-30 |
| 1972097657 | Impact Rehab Consultants | Occupational Therapist | 114 West 7th Street, Okmulgee, OK 74447 | 2018-06-18 |
| 1992192504 | Taquia Bagby | Counselor | 1117 Martin L King Dr., Okmulgee, OK 74447 | 2015-04-21 |
| 1174935886 | Heather Houser | Case Manager/Care Coordinator | 1803 South Wood Drive, Okmuglee, OK 74447 | 2014-05-29 |
| 1376977066 | Anita Kaye Stallings | Case Manager/Care Coordinator | 1018 E 2nd St, Okmulgee, OK 74447 | 2013-08-29 |
| 1013283209 | Megan Breffney Wilson | Family Medicine | 112 West 5th Street, Okmulgee, OK 74447 | 2012-04-01 |
| 1245475466 | Mary Jones | Counselor | 323 W 6th Street, Okmulgee, OK 74447 | 2008-12-03 |
| 1881872182 | State of Oklahoma | Skilled Nursing Facility | 900 E. Airport Rd., Okmulgee, OK 74447 | 2008-02-08 |
| 1053539965 | Shannon Michelle Allison | Physical Therapist | 900 E. Airport Road, Okmulgee, OK 74447 | 2007-04-23 |
| 1023233772 | Ky Joel Kiger | Physical Therapist | 900 East Airport Road, Okmulgee, OK 74447 | 2007-04-16 |
| Find all providers in zip 74447 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578919064 | Sarah Bedinghaus | Counselor | 1803 S Wood Dr, Okmulgee, OK 74447-6825 | 2016-05-13 |
| 1891049300 | James Joseph Quinn | Counselor | 104 N Oklahoma Ave, Okmulgee, OK 74447-2932 | 2012-11-06 |
| 1174874275 | Emma Lee De La Cruz | Counselor | 100 W 7th St, Okmulgee, OK 74447-5007 | 2012-09-28 |
| 1578767943 | Sharon Dalrymple | Counselor | 323 W 6th St, Okmulgee, OK 74447-5019 | 2007-06-12 |
| 1861580375 | Brent Matthew Black | Counselor | 114 N Grand Ave, Suite 419, Okmulgee, OK 74447-4013 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437758224 | Taylor Christine Clinton | Counselor | 3838 Nw 36th St Ste 300, Oklahoma City, OK 73112-2970 | 2020-10-22 |
| 1093328346 | Kathryn Glover Bishop | Counselor | 5921 E 97th St, Tulsa, OK 74137-5011 | 2020-08-26 |
| 1528670239 | Grand Lake Therapeutics LLC | Counselor | 1441 Lakeside Dr, Grove, OK 74344-4223 | 2020-08-24 |
| 1164034898 | Heather Jean Miller | Counselor | 1320 E 9th St Ste 8, Edmond, OK 73034-5773 | 2020-08-24 |
| 1225640337 | Michelle Davis Gannaway | Counselor | 13315 N Coltrane Rd, Edmond, OK 73013-8257 | 2020-08-19 |
| 1841801321 | Yolanda Cummings Counseling, Inc. | Counselor | 24900 County Road 1512, Ada, OK 74820-0994 | 2020-08-10 |
| 1518585595 | Twelfth House Wellness LLC | Counselor | 1929 Nw 29th St, Oklahoma City, OK 73106-1019 | 2020-07-07 |
| 1396369286 | Advocate for Mental Health Services LLC | Counselor | 1300 Mcgee Dr Ste 103, Norman, OK 73072-5858 | 2020-06-05 |
| 1639791221 | Santa Gladys Velez | Counselor | 1215 Crossroads Blvd Ste 212, Norman, OK 73072-3391 | 2020-05-18 |
| 1801415898 | Powerful Design Consulting, LLC | Counselor | 122 E Woodcraft Rd, Bennington, OK 74723-1833 | 2020-04-10 |
| Find all providers with the same taxonomy | ||||
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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.