TENKILLER BEHAVIORAL SERVICES, INC. (NPI# 1376967216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376967216 |
| Entity Type | Organization |
| Organization Name | TENKILLER BEHAVIORAL SERVICES, INC. |
| Practice Address |
110 W Maple St Stilwell OK 74960-3100 |
| Mailing Address |
27753 S Welling Rd Welling OK 74471-2202 |
| Practice Telephone | 9187977786 |
| Practice Fax Number | 9186968679 |
| Mailing Telephone | 9187977786 |
| Mailing Fax Number | 9184574104 |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2014-02-12 |
| Authorized Official Name | KRISTA MICHELLE ROACH (ADMINISTRATOR) |
| Authorized Official Telephone | 9187977786 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100708280 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053641373 | Tenkiller Behavioral Services, Inc. | Community/Behavioral Health | 304 N Muskogee Ave, Tahlequah, OK 74464-2738 | 2010-01-08 |
| Street Address |
110 W MAPLE ST |
| City | STILWELL |
| State | OK |
| Zip Code | 74960-3100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316360654 | Diana Miller | Counselor | 110 W Maple St, Stilwell, OK 74960 | 2014-01-22 |
| 1558858522 | Amy Renee Gifford | Counselor | 110 W Maple St, Stilwell, OK 74960-3100 | 2018-04-16 |
| 1194221507 | Chandra Hudson | Case Manager/Care Coordinator | 110 W Maple St, Stilwell, OK 74960-3100 | 2018-04-04 |
| 1437667821 | Jennifer Lynn Pettusj | Case Manager/Care Coordinator | 110 W Maple St, Stilwell, OK 74960-3100 | 2018-01-19 |
| 1083143036 | Lisa Nicole Kimble | Case Manager/Care Coordinator | 110 W Maple St, Stilwell, OK 74960-3100 | 2017-06-05 |
| 1841734753 | Dawn Martin | Counselor | 110 W Maple St, Stilwell, OK 74960-3100 | 2016-12-12 |
| 1174070627 | Bryan Lee Maloney | Counselor | 110 W Maple St, Stilwell, OK 74960-3100 | 2016-09-01 |
| 1265891246 | Robert Nathaniel Wheeler Sr. | Case Manager/Care Coordinator | 110 W Maple St, Stilwell, OK 74960-3100 | 2016-02-18 |
| 1164813960 | Alisha Tanille Drain | Student in an Organized Health Care Education/Training Program | 110 W Maple St, Stilwell, OK 74960-3100 | 2015-02-16 |
| 1477959005 | Leaha Patterson | Case Manager/Care Coordinator | 110 W Maple St, Stilwell, OK 74960-3100 | 2014-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598362964 | Madison Kitchens | Physician Assistant | 471688 Ok-51, Stilwell, OK 74960 | 2020-10-07 |
| 1356983324 | Jessica Ann Jarvis | Technician | Stilwell Public School, 520 W. Division St., Stilwell, OK 74960 | 2019-10-11 |
| 1689130593 | Georgia Delain Lowe | Licensed Practical Nurse | Route 6 Number 840, Stilwell, OK 74960 | 2019-02-15 |
| 1902321797 | Rocky Mountain School District No 24 | Local Education Agency (LEA) | Rr 1, B 665, Stilwell, OK 74960 | 2017-08-14 |
| 1912454075 | Mandi Faddis | Technician, Other | Rt 3 Box 2510, Stilwell, OK 74960 | 2016-09-07 |
| 1932566601 | Mandy Richardson | Technician | 1801 S Loucust, Stilwell, OK 74960 | 2016-01-26 |
| 1396129557 | Matthew Glenn Reece | Dentist | Hwy 51 East, Stilwell, OK 74960 | 2015-07-16 |
| 1356789838 | Sandra Marie Holmes | Speech-Language Pathologist | 100 Maryetta Road, Stilwell, OK 74960 | 2013-06-06 |
| 1306118831 | Joseph William Taylor | Counselor | Rr 1 Box 1536, Stilwell, OK 74960 | 2012-01-30 |
| 1033494224 | Crystal Cox | Counselor | Rt 1 Box 1145, Stilwell, OK 74960 | 2011-10-19 |
| Find all providers in zip 74960 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326318668 | Krystin Cherie James | Community/Behavioral Health | Rr 1 Box 1565, Stilwell, OK 74960-9752 | 2012-01-04 |
| 1881970267 | Kayla Lachele Fell | Community/Behavioral Health | 1000 W Elm St, Stilwell, OK 74960-3417 | 2011-10-29 |
| 1225333826 | Creoks Mental Health Services | Community/Behavioral Health | 716 S 2nd St Ste 101, Stilwell, OK 74960-4806 | 2011-01-13 |
| 1942732425 | Adair County Family Services | Community/Behavioral Health | 13 S 2nd St, Stilwell, OK 74960-3105 | 2017-04-03 |
| 1053721894 | Phoenix Counseling Services LLC | Community/Behavioral Health | Rr 6 Box 5, Stilwell, OK 74960-9501 | 2014-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073623 | Keonte Criswell | Community/Behavioral Health | 11530 Andover Ct, Oklahoma City, OK 73130-8217 | 2020-11-05 |
| 1427656909 | Against All Odds Youth and Family Services | Community/Behavioral Health | 2701 Nw 185th St, Edmond, OK 73012-9795 | 2020-10-15 |
| 1730798117 | Healing Minds Counseling LLC | Community/Behavioral Health | 5300 N Meridian Ave Ste 11, Oklahoma City, OK 73112-2179 | 2020-07-30 |
| 1477170322 | Glostars LLC | Community/Behavioral Health | 19704 Vivace Dr, Edmond, OK 73012-5232 | 2020-06-26 |
| 1780201798 | Canadian County Collaborative LLC | Community/Behavioral Health | 1703 Professional Cir Ste 201, Yukon, OK 73099-6498 | 2020-06-26 |
| 1235754458 | New Life Counseling Center | Community/Behavioral Health | 1206 N Hwy 81, Duncan, OK 73533-1790 | 2020-06-12 |
| 1770108946 | Meadow Hazelhoff Counseling, LLC | Community/Behavioral Health | 9524 Conners Way, Mcloud, OK 74851-8668 | 2020-06-12 |
| 1407477920 | Keetoowah Economic Development | Community/Behavioral Health | 16414 W 760 Rd, Tahlequah, OK 74464-1675 | 2020-05-06 |
| 1992336481 | Share More Ctc, LLC | Community/Behavioral Health | 2000 N Broadway St Ste B, Moore, OK 73160-4416 | 2020-02-03 |
| 1356981138 | Grand Lake Mental Health Center Inc | Community/Behavioral Health | 2225 N Union, Ponca City, OK 74601-1536 | 2020-01-09 |
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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.