BRENDA GAYLE CLARK (NPI# 1467679175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467679175 |
| Entity Type | Individual |
| Full Name | BRENDA GAYLE CLARK |
| Practice Address |
109 S. Harrill Wagoner OK 74467-5317 |
| Practice Telephone | 9184853554 |
| Practice Fax Number | 9184858371 |
| Mailing Telephone | 9184853554 |
| Mailing Fax Number | 9184858371 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265083497 | Brenda Clark | Technician | 5824 Catalina Dr, Columbus, GA 31909-4660 | 2019-09-29 |
| 1346592946 | Brenda Flynn Clark | Social Worker | 601n State St, Ukiah, CA 95482-4026 | 2012-10-05 |
| 1346536802 | Brenda J. Clark | Massage Therapist | 19626 Nara Vista Dr, Tomball, TX 77377-3478 | 2011-06-23 |
| 1629373881 | Brenda Jill Clark | Nurse Practitioner | 2312 Ridgeway Ave, Oskaloosa, IA 52577-9109 | 2011-01-20 |
| 1710147798 | Brenda S Clark | Speech-Language Pathologist | 7501 Otoe Pl, Lincoln, NE 68506-3636 | 2008-06-12 |
| 1417979576 | Brenda B Clark | Physician Assistant | 371 Nc Hwy 65, Suite204 Rockingham Co. Dept of Public Health, Wentworth, NC 27375-0204 | 2006-07-24 |
| 1760479661 | Brenda Clark | Nurse Practitioner | 5717 Albemarle Rd, Charlotte, NC 28212-1634 | 2005-10-05 |
| 1881245850 | Brenda B Clark | Registered Nurse | 6565 Fannin St, Houston, TX 77030-2703 | 2019-09-21 |
| 1255820569 | Brenda Clark | Social Worker | 4641 Fulton Dr Nw, Canton, OH 44718-2384 | 2018-05-02 |
| 1376050914 | Brenda Belden Clark | Pharmacist | 8075 N Shadeland Ave Ste 200, Indianapolis, IN 46250-2693 | 2018-01-04 |
| Street Address |
109 S. HARRILL |
| City | WAGONER |
| State | OK |
| Zip Code | 74467-5317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275750275 | Kathy Sue Mobus | Counselor | 109 S. Harrill, Wagoner, OK 74467 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982251591 | Alesha Lenard | Behavior Technician | 901 S. Harrill Ave, Wagoner, OK 74467 | 2019-08-20 |
| 1679030597 | Lorri Dawn Pitchford | Case Manager/Care Coordinator | Creoks Behavioral Health Services, 109 S Harrill Ave., Wagoner, OK 74467 | 2019-02-27 |
| 1144769399 | Elaina Murray | Technician | 308 Ne 2nd St., Wagoner, OK 74467 | 2017-02-21 |
| 1336699784 | Tommye Evidson | Counselor | 109 Harrill Ave, Wagoner, OK 74467 | 2016-10-10 |
| 1518327857 | Yco Tulsa, Inc | Clinic/Center | 1101a South Mcquarrie, Wagoner, OK 74467 | 2016-02-29 |
| 1396117545 | Sandra Cooper | Behavioral Analyst | 2109 Us-69, Wagoner, OK 74467 | 2015-10-28 |
| 1588051486 | Penny Nye | Counselor | 2109 S.hwy 69, Wagoner, OK 74467 | 2015-04-20 |
| 1376943571 | Justin F Kurtz | Respiratory Therapist, Certified | 1200 W. Cherokee, Suite H Cardiac/pulmonary Rehab, Wagoner, OK 74467 | 2014-08-26 |
| 1780009969 | David H Good | Family Medicine | 1202 W. Cherokee St, Ste E, Wagoner, OK 74467 | 2014-02-25 |
| 1942598875 | Robin Rodriguez-higginbottom | Speech-Language Pathologist | 215 E Cherokee St, Wagoner, OK 74467 | 2011-07-12 |
| Find all providers in zip 74467 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336699784 | Tommye Evidson | Counselor | 109 Harrill Ave, Wagoner, OK 74467 | 2016-10-10 |
| 1649691908 | Shawn Wall | Counselor | 68470 S 315 Rd, Wagoner, OK 74467-6292 | 2014-01-03 |
| 1811209422 | Judith Kay Beck | Counselor | 905 Brittany, Wagoner, OK 74467-8192 | 2010-07-12 |
| 1700915337 | Melissa Ann Mcdaris | Counselor | 706 Sw 3rd St, Wagoner, OK 74467-5515 | 2007-03-02 |
| 1740433358 | Jonathan David Pierce | Counselor | 109 S Harrill Ave, Wagoner, OK 74467-5317 | 2008-10-28 |
| 1003090903 | James C Washington | Counselor | 301 Se 11th St, Wagoner, OK 74467-7513 | 2007-12-27 |
| 1346431343 | Cheryl Legg | Counselor | 109 S Harrill Ave, Wagoner, OK 74467-5317 | 2007-08-05 |
| 1376664136 | Norma C Cobb | Counselor | 109 S Harrill Ave, Wagoner, OK 74467-5317 | 2007-04-02 |
| 1811018443 | Daniel K Wellmeier I | Counselor | 109 S Harrill Ave, Wagoner, OK 74467-5317 | 2007-04-02 |
| 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.