KICKAPOO HEALTH CENTER (NPI# 1407128572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407128572 |
| Entity Type | Organization |
| Organization Name | KICKAPOO HEALTH CENTER |
| Practice Address |
105365 S.highway 102 Mcloud OK 74851 |
| Mailing Address |
Po Box 1059 Mcloud OK 74851-1059 |
| Practice Telephone | 4059642618 |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-03 |
| Authorized Official Name | CHRISTINE S. MCKINNEY (CASE MANAGER) |
| Authorized Official Telephone | 4059642618 |
| Authorized Official Credential | BACHELORS DEGREE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
105365 S.HIGHWAY 102 |
| City | MCLOUD |
| State | OK |
| Zip Code | 74851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770039489 | Victoria Morris | Counselor | 13251 S. Mcloud Rd., Mcloud, OK 74851 | 2016-09-01 |
| 1922417674 | Brenda Davis | Registered Nurse | 105365 South Hwy 102, Mcloud, OK 74851 | 2014-08-07 |
| 1710390323 | Mcloud Dental Center P.l.l.c. | Dentist | 806 South 8th Street, Mcloud, OK 74851 | 2014-06-11 |
| 1508116542 | Kathryn Dean Jones | Pharmacist | 105365 South Highway 102, Mcloud, OK 74851 | 2012-09-18 |
| 1326349549 | Lisa A Lauderdale | Pharmacist | 409 North Hwy 102, Mcloud, OK 74851 | 2010-11-04 |
| 1265733539 | Mark I Gomez | Counselor | 105365 Highway102, Mcloud, OK 74851 | 2010-11-03 |
| 1396055679 | Cynthia Seger | Dietitian, Registered | 407 N. Highway 102, Mcloud, OK 74851 | 2010-10-20 |
| 1649595869 | Keith Allen Mehner | Dentist | 403 West Broadway Avenue, Mcloud, OK 74851 | 2010-03-30 |
| 1326203480 | Tyler Wellhausen | Pharmacist | 409 N Hwy 102, Mcloud, OK 74851 | 2008-07-28 |
| 1902069206 | Moira Ambrose Redcorn | Psychiatry & Neurology | 105365 S. Highway 102, Mcloud, OK 74851 | 2008-07-07 |
| Find all providers in zip 74851 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326570482 | Jessica Proper | Counselor | 143 Folsom Dr, Mcloud, OK 74851-8049 | 2017-03-29 |
| 1700130200 | Victoria Lynn Mclearen | Counselor | 9301 Megans Way, Mcloud, OK 74851-5131 | 2012-11-05 |
| 1356620744 | Claudia Garcia | Counselor | 11701 Knoll Ridge Ln, Mcloud, OK 74851-8424 | 2011-08-16 |
| 1023338514 | Rainey Martin Trussel | Counselor | 32801 Highway 270, Mcloud, OK 74851-8141 | 2010-06-07 |
| 1417142704 | Dara Beth Thorpe | Counselor | 404 N. Hwy. 102, Mcloud, OK 74851-1059 | 2007-09-10 |
| 1205268430 | Madyson Elise Roark | Counselor | 29501 Kickapoo Rd, Mcloud, OK 74851-8320 | 2013-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039517 | Tommy Craig Smith | Counselor | 3601 N Classen Blvd Ste 102, Oklahoma City, OK 73118-3231 | 2020-09-29 |
| 1881200558 | Nichole Rae Krausch | Counselor | 1507 S Mckenna St, Poteau, OK 74953-5207 | 2020-09-18 |
| 1467068098 | Mckenzie Mcguffee | Counselor | 717 Briarcrest Dr, Midwest City, OK 73110-1619 | 2020-09-18 |
| 1629683727 | Mason Counseling Services | Counselor | 12718 E 77th Pl N, Owasso, OK 74055-7938 | 2020-09-15 |
| 1437761004 | Ashley Jane Runnells | Counselor | 4867 S Sheridan Rd Ste 712a, Tulsa, OK 74145-5721 | 2020-08-17 |
| 1982214292 | Tera Dee Robbins | Counselor | 1002 Cambell Street, Warner, OK 74469 | 2020-08-03 |
| 1619587946 | Chelsey S Kopaddy | Counselor | 1108 Nw Elm Ave, Lawton, OK 73507-4607 | 2020-08-02 |
| 1932718376 | David Louis Holden | Counselor | 1803 W Wood Drive, Okmulgee, OK 74447 | 2020-07-30 |
| 1043829278 | Tracy Nanette Mckeown | Counselor | 1777 S Yukon Pkwy, Yukon, OK 73099-4599 | 2020-07-23 |
| 1063039915 | Sarah Nicole Hawthorne | Counselor | 12834 S Old Highway 169, Oologah, OK 74053-3333 | 2020-06-26 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KICKAPOO HEALTH CENTER.
| 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.