MYSTERY GAYLE BEAR


Address: 111 S Treaty Rd, Miami, OK 74354-5327
Phone: 9185401511

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 175T00000X Peer Specialist Other Service Providers

Office Location

Street Address 111 S TREATY RD
City MIAMI
State OK
Zip Code 74354-5327

Providers in the same location

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
Find all providers in the same location

Providers in the same zip code

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 Information

Taxonomy Code 175T00000X
Grouping Other Service Providers
Classification Peer Specialist

Taxonomy Definition

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]

Providers in the same taxonomy and city

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
Find all providers in MIAMI

Competitor

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City MIAMI
Zip Code 74354

Improve Information

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Dataset Information

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.

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