DR. JOANNA OMEGA SHADLOW (NPI# 1316123946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316123946 |
| Entity Type | Individual |
| Full Name | DR. JOANNA OMEGA SHADLOW |
| Credential | PHD |
| Practice Address |
550 S Peoria Ave Tulsa OK 74120-3820 |
| Practice Telephone | 9185881900 |
| Practice Fax Number | 9185826405 |
| Mailing Telephone | 9185881900 |
| Mailing Fax Number | 9185826405 |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2015-06-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 1172 | OK | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | GROUP COMMUNITY CARE OF OKLAHOMA | 73-1042545 | 01 |
| OK | GROUP MEDICAID/SOONERCARE | 100732910-A | 01 |
| OK | GROUP BCBS | 73-1042545 | 01 |
| OK | GROUP MEDICAID/SOONERCARE | 100732910-G | 01 |
| OK | GROUP MEDICARE | 73-1042545 | 01 |
| OK | GROUP TRICARE | 731042545001 | 01 |
| Street Address |
550 S PEORIA AVE |
| City | TULSA |
| State | OK |
| Zip Code | 74120-3820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871538942 | Carolyn Louise Cobb | Emergency Medicine | 550 S Peoria Ave, Tulsa, OK 74120-3820 | 2006-06-20 |
| 1487266540 | Tanya Lee Cain | Registered Nurse | 550 S Peoria Ave, Tulsa, OK 74120-3820 | 2020-08-20 |
| 1851903918 | Alicia Kay Ortman | Licensed Practical Nurse | 550 S Peoria Ave, Tulsa, OK 74120-3820 | 2020-08-20 |
| 1790397982 | Linda Lynn Almanza | Licensed Practical Nurse | 550 S Peoria Ave, Tulsa, OK 74120-3820 | 2020-08-19 |
| 1437761517 | Brenda Gayle Taylor | Licensed Practical Nurse | 550 S Peoria Ave, Tulsa, OK 74120-3820 | 2020-08-19 |
| 1780296871 | Jessica Ranae Rimer | Licensed Practical Nurse | 550 S Peoria Ave, Tulsa, OK 74120-3820 | 2020-08-19 |
| 1255943437 | Treece Louise Sutton | Licensed Practical Nurse | 550 S Peoria Ave, Tulsa, OK 74120-3820 | 2020-08-19 |
| 1093327603 | Keenan Charles Reed | Licensed Practical Nurse | 550 S Peoria Ave, Tulsa, OK 74120-3820 | 2020-08-17 |
| 1861004467 | Shannon Renee Woodstock | Licensed Practical Nurse | 550 S Peoria Ave, Tulsa, OK 74120-3820 | 2020-08-17 |
| 1437760261 | Anne Marie Lisko | Registered Nurse | 550 S Peoria Ave, Tulsa, OK 74120-3820 | 2020-08-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144704321 | Quintella Delana Miller | Case Manager/Care Coordinator | 1043 E Easton St, Tulsa, OK 74120 | 2018-09-24 |
| 1689152092 | Charles Granger Jr. | Case Manager/Care Coordinator | 103 N Greenwood, Suite 320, Tulsa, OK 74120 | 2018-07-30 |
| 1174015598 | Debra Anne Beasley | Counselor | 1619 E. 13th St., Tulsa, OK 74120 | 2018-06-01 |
| 1649775701 | Cara Marie Cantu | Licensed Practical Nurse | 620 South Peoria, Tulsa, OK 74120 | 2018-03-29 |
| 1639558745 | Wei Te Li | Student in an Organized Health Care Education/Training Program | 1207 S Quaker Ave Apt 104, Tulsa, OK 74120 | 2015-05-21 |
| 1225434350 | Marcos Rivero | Community/Behavioral Health | 130 N. Greenwood, Suite 302, Tulsa, OK 74120 | 2014-11-18 |
| 1861742348 | Tamiika Jones | Social Worker | 1533 E 13th St, Apt B, Tulsa, OK 74120 | 2012-09-12 |
| 1730408097 | Teresa Lee Henshaw | Physical Therapist | 1125 S. Trenton, Hillcrest Medical Center- Kaiser Rehab. Center, Tulsa, OK 74120 | 2010-05-26 |
| 1194970384 | Kym Lynnette Lindsay | Speech-Language Pathologist | 1125 S Trenton Ave Fl 3, Tulsa, OK 74120 | 2008-12-01 |
| 1184872004 | Board of Regents of The University of Oklahoma Ou Physicians Tulsa | Pediatrics | 619 S. Quincy Ave., Ouptch-laura Dester Shelter, Tulsa, OK 74120 | 2008-09-04 |
| Find all providers in zip 74120 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023557139 | Stephen Grissom | Psychologist | 3736 E 82nd Pl, Tulsa, OK 74137-1605 | 2017-02-22 |
| 1508116526 | Martin Stampley Jr. | Psychologist | 1769 W Fairview St, Tulsa, OK 74127-4924 | 2012-09-17 |
| 1164716965 | Melanie Erica Mcquiddy | Psychologist | 5800 E Skelly Dr Ste 1111, Tulsa, OK 74135 | 2011-06-09 |
| 1881917151 | Bart Trentham, Pllc | Psychologist | 4870 S Lewis Ave -180 Tuls., Tulsa, OK 74105 | 2010-03-01 |
| 1336473784 | Paul Cooper | Psychologist | 7220 E 55th Place, Tulsa, OK 74145 | 2009-10-01 |
| 1538301189 | Terese Ann Hall | Psychologist | 5272 S Lewis Ave Ste 112, Tulsa, OK 74105-6563 | 2009-03-28 |
| 1962663856 | Judith K. Adams, Inc. | Psychologist | 9726 East 42nd Street So., Suite 106, Tulsa, OK 74146-3673 | 2008-06-23 |
| 1912104373 | Wendy Marie Huckeba | Psychologist | 5970 E 31st St Ste F, Tulsa, OK 74135-5112 | 2007-06-29 |
| 1235341389 | Thomas Alan Dafforn | Psychologist | 4870 S Lewis Avenue, Suite 180, Tulsa, OK 74105-5141 | 2007-05-03 |
| 1376760504 | Dennis A. Rawlings | Psychologist | 5215 E 71st St Ste 1400, Tulsa, OK 74136-6346 | 2007-04-19 |
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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.