MICHELLE GRIMMER (NPI# 1265897656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265897656 |
| Entity Type | Individual |
| Full Name | MICHELLE GRIMMER |
| Practice Address |
405 E Excelsior Ave Vinita OK 74301-4226 |
| Practice Telephone | 9182566476 |
| Practice Fax Number | 9182563628 |
| Mailing Telephone | 9182566476 |
| Mailing Fax Number | 9182563628 |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
6565 | OK | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1805 N York St, G, Muskogee, OK 744031404 | 9186829292 | 9186820054 |
| Street Address |
405 E EXCELSIOR AVE |
| City | VINITA |
| State | OK |
| Zip Code | 74301-4226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710994835 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2006-08-02 |
| 1023625563 | Steven Ray Coatney | Peer Specialist | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-09-29 |
| 1932712775 | Karen Tiscareno | Peer Specialist | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-08-30 |
| 1669085528 | Felicia Johnson | Peer Specialist | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-08-28 |
| 1508474982 | Kari West | Case Manager/Care Coordinator | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-07-21 |
| 1770108920 | India Leigh Uhlemeyer | Peer Specialist | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-06-13 |
| 1356964399 | Allison L Andrasko | Registered Nurse | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-05-26 |
| 1861013070 | Chad H Wiens | Registered Nurse | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-04-28 |
| 1154940005 | Lisa R Farbro | Case Manager/Care Coordinator | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-04-10 |
| 1215569413 | Laytin Allen Parker | Peer Specialist | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2020-02-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740786 | Jennifer Lynn Black | Registered Nurse | 24919 S 4420 Road, Vinita, OK 74301 | 2020-11-03 |
| 1720686272 | Chancie Marie Cooper | Case Manager/Care Coordinator | 444 737 Hwy 28, Vinita, OK 74301 | 2020-10-15 |
| 1265082515 | Ruth Irving | Technician | 843 North Miller, Vinita, OK 74301 | 2019-09-18 |
| 1952897449 | Sarah Renee Gilmore | Behavior Technician | 526 N. Brewer, Vinita, OK 74301 | 2018-07-08 |
| 1134664683 | Sheila Mason | Nurse Practitioner | Department of Veterans Affairs Clinic, 269 South 7th Street, Vinita, OK 74301 | 2016-12-19 |
| 1881145274 | Saint Francis Hospital Vinita, Inc | Clinic/Center | 711 North Brewer Street, Vinita, OK 74301 | 2016-10-20 |
| 1699147249 | Beth Powell | Peer Specialist | 405 East Excelsior Ave, Vinita, OK 74301 | 2015-10-22 |
| 1790196202 | Peter Rausch | Psychologist | 735 N. Foreman St., Vinita, OK 74301 | 2014-05-19 |
| 1548605041 | Anita Joy Cantrell | Counselor | 1520 North Industrial Ave, Vinita, OK 74301 | 2013-05-10 |
| 1033469606 | Matt Lance Oldacre | Pharmacist | 525 S. Wilson, Vinita, OK 74301 | 2012-09-11 |
| Find all providers in zip 74301 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245372424 | Jeffrey David Prusa | Counselor | 1520 Industrial Ave, Vinita, OK 74301-4803 | 2007-02-13 |
| 1427110295 | Rocmnd Area Youth Services, Inc. | Counselor | 1520 N Industrial Road, Vinita, OK 74301 | 2006-12-15 |
| 1891210142 | Shelly Janae Brown | Counselor | 405 E Excelsior Ave, Vinita, OK 74301 | 2017-08-08 |
| 1114242971 | Sheryl Smith | Counselor | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2010-04-05 |
| 1437383320 | Chris Herrera | Counselor | 24919 S 4420 Rd, Vinita, OK 74301-5529 | 2009-05-07 |
| 1205056496 | Diane B Hamilton | Counselor | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2007-04-27 |
| 1356479943 | Kevan Brian Finley | Counselor | 24800 S 4420 Rd, Vinita, OK 74301-5544 | 2007-03-02 |
| 1053475202 | Rocmnd Area Youth Services, Inc. | Counselor | 1520 N Industrial Road, Vinita, OK 74301 | 2006-12-21 |
| 1316001563 | Rocmnd Area Youth Services, Inc. | Counselor | 1520 N Industrial Road, Vinita, OK 74301-0912 | 2006-12-21 |
| 1952465106 | Rocmnd Area Youth Services, Inc. | Counselor | 1520 N Industrial Road, Vinita, OK 74301 | 2006-12-21 |
| Find all providers in VINITA | ||||
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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.