MS. SHANNA RENELL WILLOUGHBY (NPI# 1437345105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437345105 |
| Entity Type | Individual |
| Full Name | MS. SHANNA RENELL WILLOUGHBY |
| Practice Address |
300 N Dalton St Valliant OK 74764 |
| Mailing Address |
Rr 1 Box 257 Garvin OK 74736-9746 |
| Practice Telephone | 5802865777 |
| Practice Fax Number | 5802865132 |
| Mailing Telephone | 5802865777 |
| Mailing Fax Number | 5802865132 |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2007-09-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
20028 | OK | Behavioral Health & Social Service Providers |
| Street Address |
300 N DALTON ST |
| City | VALLIANT |
| State | OK |
| Zip Code | 74764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679194765 | Kayli Breanne Clift | Case Manager/Care Coordinator | 300 N Dalton St, Valliant, OK 74764-8029 | 2020-04-30 |
| 1033764113 | Lauren Diane Box | Case Manager/Care Coordinator | 300 N Dalton St, Valliant, OK 74764-8029 | 2019-08-06 |
| 1417502782 | Sheila Diane Rock | Counselor | 300 N Dalton St, Valliant, OK 74764-8029 | 2019-08-05 |
| 1104487883 | Rhoda Eola Holleman | Case Manager/Care Coordinator | 300 N Dalton St, Valliant, OK 74764-8029 | 2019-06-24 |
| 1063908903 | April Jo Swearingin | Peer Specialist | 300 N Dalton St, Valliant, OK 74764-8029 | 2018-07-03 |
| 1336669795 | Shakila Sorrells | Counselor | 300 N Dalton St, Valliant, OK 74764-8029 | 2017-06-26 |
| 1831568377 | Stephanie Erlitz | Case Manager/Care Coordinator | 300 N Dalton St, Valliant, OK 74764-8029 | 2015-09-15 |
| 1851703557 | Debborah Harp | Case Manager/Care Coordinator | 300 N Dalton St, Valliant, OK 74764-8029 | 2014-05-29 |
| 1780929703 | Stephanie Heffner | Counselor | 300 N Dalton St, Valliant, OK 74764-8029 | 2012-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003156571 | Paula Beard | Counselor | 701 Nation Rd, Valliant, OK 74764 | 2013-02-21 |
| 1437446127 | Essent Prmc, Lp | Clinic/Center | 514 East Wilson, Valliant, OK 74764 | 2011-07-01 |
| 1841456563 | Amy Causey | Counselor | 300 N Dalton Ave, Valliant, OK 74764 | 2008-08-01 |
| 1093979825 | Sabrina Johnson | Case Manager/Care Coordinator | 300 N Dalton Avenue, Valliant, OK 74764 | 2008-07-10 |
| 1477768125 | Frank Dewayne Coolbroth II | Counselor | 300 North Dalton, Valliant, OK 74764 | 2007-05-14 |
| 1447464623 | Dionnw Frankum | Counselor | 300 N. Dalton, Valliant, OK 74764 | 2007-05-09 |
| 1104030402 | Valliant House, LLC | Substance Abuse Rehabilitation Facility | 300 N. Dalton Ave, Valliant, OK 74764 | 2007-05-09 |
| 1376757484 | Jason Baker | Counselor | 300 N. Dalton Avenue, Valliant, OK 74764 | 2007-05-09 |
| 1720118276 | Altis Beatrice Rutherford | Counselor | 300 N Dalton, Valliant, OK 74764 | 2007-03-06 |
| 1750470969 | Bolton Drug & Jewelry | Pharmacy | #3 N Dalton, Valliant, OK 74764 | 2006-10-12 |
| Find all providers in zip 74764 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073765442 | Gina Diane Rice | Counselor | Rr 2 Box 374-5, Valliant, OK 74764-9807 | 2008-10-16 |
| 1841456563 | Amy Causey | Counselor | 300 N Dalton Ave, Valliant, OK 74764 | 2008-08-01 |
| 1477768125 | Frank Dewayne Coolbroth II | Counselor | 300 North Dalton, Valliant, OK 74764 | 2007-05-14 |
| 1417502782 | Sheila Diane Rock | Counselor | 300 N Dalton St, Valliant, OK 74764-8029 | 2019-08-05 |
| 1336669795 | Shakila Sorrells | Counselor | 300 N Dalton St, Valliant, OK 74764-8029 | 2017-06-26 |
| 1457678849 | Tara Price | Counselor | 300 N Dalton Ave, Valliant, OK 74764 | 2010-04-26 |
| 1790937076 | Martha Hensley | Counselor | 300 N Dalton Ave, Valliant, OK 74764 | 2008-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295341337 | Juan Miguel Jimenez | Counselor | 713 Nw 139th St, Edmond, OK 73013-1912 | 2020-09-22 |
| 1790396042 | Amazing Life Behavioral Health and Addiction Services | Counselor | 324 N 19th St Ste 101, Guthrie, OK 73044-2117 | 2020-08-11 |
| 1144839994 | Jill Brittny Johnson | Counselor | 2840 Nw 31st St, Oklahoma City, OK 73112-7407 | 2020-07-28 |
| 1417565243 | Angela Darlene Brooks | Counselor | 3605 Ne 142nd Ct, Edmond, OK 73013-7224 | 2020-07-17 |
| 1285252304 | Max Anna Hanna | Counselor | 2600 W. Coffee Creek Rd, Edmond, OK 73025 | 2020-07-07 |
| 1366060444 | John Christopher Lewis | Counselor | 6302 N Garrison Ave, Tulsa, OK 74126-1512 | 2020-07-06 |
| 1710502505 | Sally Smith | Counselor | 4525 Southcreek Rd, Moore, OK 73165-7359 | 2020-06-08 |
| 1487273223 | Maxwell Brown Enterprise, LLC | Counselor | 250 E Apache St, Tulsa, OK 74106-3702 | 2020-04-12 |
| 1679105068 | Audrey June Halfacre | Counselor | 4803 Ridge St, Tahlequah, OK 74464-5644 | 2020-02-04 |
| 1760021984 | Damilola Mosebolatan Akintola | Counselor | 5013 Oak Manor Dr, Oklahoma City, OK 73135-2235 | 2020-01-06 |
| Find all providers with the same taxonomy | ||||
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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.