DR. ANDREA DENICE DUDLEY (NPI# 1245386788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245386788 |
| Entity Type | Individual |
| Full Name | DR. ANDREA DENICE DUDLEY |
| Credential | PHD |
| Practice Address |
301 J T Stites Blvd Sallisaw OK 74955-9302 |
| Mailing Address |
704 W Chickasaw Ave Sallisaw OK 74955-4224 |
| Practice Telephone | 9187759150 |
| Practice Fax Number | 9187754790 |
| Mailing Telephone | 9186309729 |
| Mailing Fax Number | 9187756165 |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
3492 | OK | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568544773 | Andrea Bertalotto Dudley | Optometrist | 5910 S Lewis, Tulsa, OK 74105-7112 | 2006-10-19 |
| 1982862660 | Andrea Dudley | Counselor | 2530 South Commerce, Ardmore, OK 73401 | 2008-05-29 |
| Street Address |
301 J T STITES BLVD |
| City | SALLISAW |
| State | OK |
| Zip Code | 74955-9302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881690105 | Jeffrey S Sanders | Pharmacist | 301 J T Stites Blvd, Sallisaw, OK 74955-9302 | 2005-06-22 |
| 1396014965 | Timothy Aaron Cardenaz | Pharmacist | 301 J T Stites Blvd, Sallisaw, OK 74955-9302 | 2011-12-27 |
| 1831468198 | Leslie Ray Woodard | Pharmacist | 301 J T Stites Blvd, Sallisaw, OK 74955-9302 | 2011-12-15 |
| 1104080431 | Michael Aaron Sweeney | Dentist | 301 J T Stites Blvd, Sallisaw, OK 74955-9302 | 2008-07-16 |
| 1700040201 | Pamela Jorene West | Pharmacist | 301 J T Stites Blvd, Sallisaw, OK 74955-9302 | 2008-07-14 |
| 1841461324 | Tabitha Joanne Ford | Dietitian, Registered | 301 J T Stites Blvd, Sallisaw, OK 74955-9302 | 2008-03-12 |
| 1275743684 | Lisa D Ortiz | Internal Medicine | 301 J T Stites Blvd, Redbird Smith Health Center, Sallisaw, OK 74955-9302 | 2007-05-23 |
| 1356497812 | Richard Darren Stites | Counselor | 301 J T Stites Blvd, Sallisaw, OK 74955-9302 | 2007-01-26 |
| 1629182167 | Northeastern State University College of Optometry | Eyewear Supplier (Equipment, not the service) | 301 J T Stites Blvd, Sallisaw, OK 74955-9302 | 2006-08-19 |
| 1184675464 | Sheryl Evone Ghan | Pediatrics | 301 J T Stites Blvd, Sallisaw, OK 74955-9302 | 2006-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063057297 | Audrey A. Martin | Technician | 463508 East 1044 Road, Sallisaw, OK 74955 | 2019-11-12 |
| 1013472356 | Christopher Alan Bush | Registered Nurse | 301 Jt Stites, Sallisaw, OK 74955 | 2019-01-31 |
| 1174098941 | Sequoyah County Drug Company Pllc | Pharmacy | 1632 S Kerr Blvd, Sallisaw, OK 74955 | 2018-10-09 |
| 1720570609 | Stephanie Choate | Registered Nurse | 2703 E Phillips Ave, Sallisaw, OK 74955 | 2018-06-05 |
| 1972964666 | Sallisaw Family Medicine, L.L.C. | Family Medicine | 104 South Oak St, Sallisaw, OK 74955 | 2016-03-09 |
| 1407258544 | Mika Goff | Counselor | 301 So. Jt Stites, Sallisaw, OK 74955 | 2014-09-19 |
| 1013348200 | Alton Matlock | Counselor | 2101 Winter Park Drive, Apt/suite, Sallisaw, OK 74955 | 2013-12-12 |
| 1881931509 | Wildhorse Family Practice & Urgent Care | Clinic/Center | 1024 W Cherokee, Sallisaw, OK 74955 | 2013-01-15 |
| 1083966576 | Kayla Plank | Counselor | 204 E Choctaw, Sallisaw, OK 74955 | 2012-10-08 |
| 1427307503 | Brandi Jean Henry | Counselor | 205 S. J.t. Stites, Sallisaw, OK 74955 | 2012-09-05 |
| Find all providers in zip 74955 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114229077 | Cherese F Riggs | Counselor | 204 E. Choctaw, Sallisaw, OK 74955 | 2010-11-29 |
| 1568650463 | Candace Rae Jeffries Nichols | Counselor | 1108 N Wheeler Ave, Sallisaw, OK 74955-2227 | 2007-10-05 |
| 1730509274 | Carry Shamblin | Counselor | 204 E Choctaw Ave, Sallisaw, OK 74955-4604 | 2014-04-23 |
| 1447403878 | Christine Marie Eubanks | Counselor | 204 E Choctaw Ave, Sallisaw, OK 74955-4604 | 2008-10-29 |
| 1225233646 | Tammy Broussard | Counselor | 204 E Choctaw Ave, Sallisaw, OK 74955-4604 | 2007-06-16 |
| 1528263944 | Brian Childs | Counselor | 101 N Wheeler Ave, Sallisaw, OK 74955-4617 | 2007-06-16 |
| 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 |
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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.