MR. THOMAS CARL LIBBY II (NPI# 1477112787) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477112787 |
| Entity Type | Individual |
| Full Name | MR. THOMAS CARL LIBBY II |
| Practice Address |
401 W. Main St. Barnsdall OK 74002-5233 |
| Practice Telephone | 9188473527 |
| Practice Fax Number | 9187779018 |
| Mailing Telephone | 9188473527 |
| Mailing Fax Number | 9187779018 |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2019-07-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
401 W. MAIN ST. |
| City | BARNSDALL |
| State | OK |
| Zip Code | 74002-5233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659393015 | Jill Suzanne Sago | Counselor | 401 W. Main St., Barnsdall, OK 74002 | 2006-07-24 |
| 1790335644 | Hanna Grace Stroup | Case Manager/Care Coordinator | 401 W. Main St., Barnsdall, OK 74002 | 2019-09-12 |
| 1003469297 | Ely James Burgess | Case Manager/Care Coordinator | 401 W. Main St., Barnsdall, OK 74002-6631 | 2019-07-17 |
| 1568027951 | Amber Quillin | Case Manager/Care Coordinator | 401 W. Main St., Barnsdall, OK 74002 | 2019-05-01 |
| 1215498456 | Tanya G Williams | Case Manager/Care Coordinator | 401 W. Main St., Barnsdall, OK 74002-6631 | 2019-03-29 |
| 1275016792 | Melissa Joann Bouchard | Case Manager/Care Coordinator | 401 W. Main St., Barnsdall, OK 74002-0000 | 2018-09-11 |
| 1841779444 | Iva Collins | Case Manager/Care Coordinator | 401 W. Main St., Barnsdall, OK 74002-0000 | 2018-08-14 |
| 1437636073 | Jessi Nichol Neal | Social Worker | 401 W. Main St., Barnsdall, OK 74002 | 2018-07-26 |
| 1144736166 | Gina Leigh Stephens | Case Manager/Care Coordinator | 401 W. Main St., Barnsdall, OK 74002-5226 | 2017-12-28 |
| 1831602507 | Michael Steven Backora | Counselor | 401 W. Main St., Barnsdall, OK 74002-6631 | 2017-11-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073165866 | Chelsea Janice-marie Allen | Case Manager/Care Coordinator | 401 W. Main St., Barnsdall, OK 74002 | 2019-07-11 |
| 1841648953 | Haley Perkins | Case Manager/Care Coordinator | 401 W, Main, Barnsdall, OK 74002 | 2016-05-31 |
| 1205218146 | Megan Hudson | Social Worker | 401 W Main St., Barnsdall, OK 74002 | 2015-06-28 |
| 1801078621 | Lura Lea Jaquess | Social Worker | 609 Cedar Ave., Barnsdall, OK 74002 | 2007-12-04 |
| 1881686186 | Marcus D Sizemore | Physician Assistant | 112 N 5th, Barnsdall, OK 74002 | 2005-08-22 |
| 1740822493 | Andrea Cousparis | Social Worker | 401 West Main Street, Barnsdall, OK 74002 | 2019-10-15 |
| 1831749787 | Shalena Diane Pece | Case Manager/Care Coordinator | 401 W Main St, Barnsdall, OK 74002 | 2019-09-12 |
| 1386296176 | Crala Marlin | Case Manager/Care Coordinator | 401 W Main St, Barnsdall, OK 74002 | 2019-07-11 |
| 1891352290 | Mason Allan Moody | Case Manager/Care Coordinator | 401 W. Main St, Barnsdall, OK 74002 | 2019-05-22 |
| 1336702497 | Lora Lavon Mcdermott | Case Manager/Care Coordinator | 401 W Main Street, Barnsdall, OK 74002 | 2019-04-15 |
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| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639738990 | Frances Kay Garrett | Peer Specialist | 401 W Main St, Barnsdall, OK 74002-6631 | 2019-06-11 |
| 1871099630 | Johanna Leigh Chancellor | Peer Specialist | 401 W Main, Barnsdall, OK 74002-0000 | 2018-04-02 |
| 1104378983 | Brandon Chad Rogers | Peer Specialist | 401 W Main St, Barnsdall, OK 74002-0000 | 2016-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972537 | Tamra Lynn Cunningham | Peer Specialist | 764 Sherwin Ave, Ponca City, OK 74604-6112 | 2020-11-05 |
| 1699375691 | Martha Isabel Zapata | Peer Specialist | 5740 E 72nd Ct, Tulsa, OK 74136-7202 | 2020-10-28 |
| 1376143883 | Tina Marie Lopez | Peer Specialist | 933 N Oak St, Ponca City, OK 74601-3218 | 2020-10-26 |
| 1518566264 | Vincent Oaks Cox | Peer Specialist | 3585 S 439, Pryor, OK 74361-9346 | 2020-10-23 |
| 1558960146 | Sarah Elizabeth Walters | Peer Specialist | 2139 W Jasper St Apt B1, Broken Arrow, OK 74011-8028 | 2020-10-23 |
| 1861091548 | Ryan Vanmeter | Peer Specialist | 1965 Ladera Ln, Edmond, OK 73034-9787 | 2020-10-22 |
| 1255930038 | Brandon Loyd Hopkins | Peer Specialist | 446 S Scraper St, Vinita, OK 74301-4250 | 2020-10-22 |
| 1225637366 | Crystal Dawn Adams | Peer Specialist | 200 N Sante Fe Ave, Bartlesville, OK 74003 | 2020-10-20 |
| 1194324491 | Judith Anne Young | Peer Specialist | 3934 Se 27th St, Del City, OK 73115-2620 | 2020-10-19 |
| 1407455892 | Kristen Michelle Stock | Peer Specialist | 804 N Dryden Cir, Stillwater, OK 74075-7108 | 2020-10-18 |
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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.