MYSTERY GAYLE BEAR (NPI# 1265072573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265072573 |
| Entity Type | Individual |
| Full Name | MYSTERY GAYLE BEAR |
| Practice Address |
111 S Treaty Rd Miami OK 74354-5327 |
| Mailing Address |
3520 Cayuga Ave Apt D Miami OK 74354-5300 |
| Practice Telephone | 9185401511 |
| Mailing Telephone | 9183258727 |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2020-03-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
111 S TREATY RD |
| City | MIAMI |
| State | OK |
| Zip Code | 74354-5327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356333819 | Julie D Finney | Physician Assistant | 111 S Treaty Rd, Miami, OK 74354-5327 | 2005-08-19 |
| 1194336156 | Presley Ashtin Goff | Social Worker | 111 S Treaty Rd, Miami, OK 74354-5327 | 2020-08-13 |
| 1649898529 | Caressa Russell | Social Worker | 111 S Treaty Rd, Miami, OK 74354-5327 | 2020-07-08 |
| 1043838899 | Brandon Allan Maples | Peer Specialist | 111 S Treaty Rd, Miami, OK 74354-5327 | 2020-07-08 |
| 1942823190 | Zaine Alexander Gibson | Behavioral Analyst | 111 S Treaty Rd, Miami, OK 74354-5327 | 2020-05-22 |
| 1215558127 | Sydnee Marie Vance | Case Manager/Care Coordinator | 111 S Treaty Rd, Miami, OK 74354-5327 | 2020-05-01 |
| 1558981217 | Michael Shane Allen | Case Manager/Care Coordinator | 111 S Treaty Rd, Miami, OK 74354-5327 | 2020-04-23 |
| 1093335754 | Jonathan Kyle Shinn | Counselor | 111 S Treaty Rd, Miami, OK 74354-5327 | 2020-04-23 |
| 1972139475 | Lila Renee Metzker | Counselor | 111 S Treaty Rd, Miami, OK 74354-5327 | 2020-03-16 |
| 1518591254 | Amanda Wren | Case Manager/Care Coordinator | 111 S Treaty Rd, Miami, OK 74354-5327 | 2020-03-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447786603 | Coal Creek Counseling, LLC | Social Worker | 204 D St Ne, Miami, OK 74354 | 2017-05-10 |
| 1164958567 | Yco Tulsa, Inc | Counselor | 1458 E Steve Owens Blvd, Miami, OK 74354 | 2017-05-04 |
| 1982064226 | Yco Tulsa, Inc | Clinic/Center | 1519 E Steve Owens Blvd, Miami, OK 74354 | 2016-02-29 |
| 1548641285 | Courtney Marie Winfrey | Occupational Therapy Assistant | 310 2nd Ave Sw Fl 3, Miami, OK 74354 | 2015-06-17 |
| 1417338039 | Michelle Dawn Johnson | Case Manager/Care Coordinator | 1519 E. Steve Owens Blvd, Miami, OK 74354 | 2015-06-10 |
| 1790100337 | Jordan Taylor-threet | Speech-Language Pathologist | 2225 N. Main St., Miami, OK 74354 | 2014-02-19 |
| 1700137551 | Miami Healthcare, LLC | Skilled Nursing Facility | 2530 North Elm St., Miami, OK 74354 | 2012-09-19 |
| 1144507534 | Julia Brown | Pharmacist | 11 West Central, Miami, OK 74354 | 2011-11-14 |
| 1841504685 | Dodie A Giles Keith | Counselor | 33 C Street Northeast, Miami, OK 74354 | 2010-08-04 |
| 1013221571 | Katherine Renee Burke | Counselor | 111 S. Treaty Rd., Miami, OK 74354 | 2010-07-27 |
| Find all providers in zip 74354 | ||||
| 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 |
|---|---|---|---|---|
| 1174140628 | Christina Lynn Bond | Peer Specialist | 2221 Bst Ne, Miami, OK 74354-1611 | 2020-07-01 |
| 1174149900 | Lauren Beth Houk | Peer Specialist | 432 F St Se, Miami, OK 74354-8208 | 2020-06-17 |
| 1043838899 | Brandon Allan Maples | Peer Specialist | 111 S Treaty Rd, Miami, OK 74354-5327 | 2020-07-08 |
| 1538790001 | Ashley Shea Bertram | Peer Specialist | 111 S Treaty Rd, Miami, OK 74354-5327 | 2020-02-03 |
| 1316577745 | Bobbie K Folk | Peer Specialist | 58150 E 66 Rd, Miami, OK 74354-6509 | 2020-01-24 |
| 1386274710 | Alexis Austin | Peer Specialist | 111 S Treaty Rd, Miami, OK 74354-5327 | 2020-01-24 |
| 1205476470 | Kayla Christine Bellew | Peer Specialist | 111 S Treaty Rd, Miami, OK 74354-5327 | 2020-01-15 |
| 1275171274 | Grand Lake Mental Health | Peer Specialist | 111 S Treaty Rd, Miami, OK 74354-5327 | 2019-12-20 |
| 1013577139 | Justin Cicotte | Peer Specialist | 130 W Steve Owens Blvd, Miami, OK 74354-7629 | 2019-06-20 |
| 1235793365 | Monica Joy Dollison | Peer Specialist | 111 S Treaty Rd, Miami, OK 74354-5327 | 2019-04-24 |
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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.