SHANNON ROSE-SELSTAD (NPI# 1487853677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487853677 |
| Entity Type | Individual |
| Full Name | SHANNON ROSE-SELSTAD |
| Credential | BS |
| Practice Address |
1202 Sw A Ave Lawton OK 73501-3821 |
| Practice Telephone | 5803576889 |
| Practice Fax Number | 5802481090 |
| Mailing Telephone | 5803576889 |
| Mailing Fax Number | 5802481090 |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2007-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Street Address |
1202 SW A AVE |
| City | LAWTON |
| State | OK |
| Zip Code | 73501-3821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467470310 | Roadback Incorporated | Substance Abuse Rehabilitation Facility | 1202 Sw A Ave, Lawton, OK 73501-3821 | 2006-07-18 |
| 1366052532 | Avery Allen Beaty | Peer Specialist | 1202 Sw A Ave, Lawton, OK 73501-3821 | 2020-08-03 |
| 1205446531 | Debra Young Dunham | Peer Specialist | 1202 Sw A Ave, Lawton, OK 73501-3821 | 2020-08-02 |
| 1760832133 | Julie Connally | Peer Specialist | 1202 Sw A Ave, Lawton, OK 73501-3821 | 2016-06-16 |
| 1669860763 | Bronwen Gutzwiller | Student in an Organized Health Care Education/Training Program | 1202 Sw A Ave, Lawton, OK 73501-3821 | 2014-12-26 |
| 1639595473 | Coldelia White | Case Manager/Care Coordinator | 1202 Sw A Ave, Lawton, OK 73501-3821 | 2014-03-17 |
| 1083044580 | Candace Jones | Case Manager/Care Coordinator | 1202 Sw A Ave, Lawton, OK 73501-3821 | 2013-11-19 |
| 1942639901 | Heather Hennessey | Substance Abuse Rehabilitation Facility | 1202 Sw A Ave, Lawton, OK 73501-3821 | 2013-11-09 |
| 1619215746 | Shannon Lynn Scholtz | Counselor | 1202 Sw A Ave, Lawton, OK 73501-3821 | 2013-01-24 |
| 1538414065 | Michael W Rigsby | Case Manager/Care Coordinator | 1202 Sw A Ave, Lawton, OK 73501-3821 | 2012-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596729 | Alyssa K Manfredi | Speech-Language Pathologist | 1700 Nw Lee Blvd, Lawton, OK 73501 | 2020-10-21 |
| 1295079705 | Premier Behavorial Health | Community/Behavioral Health | 2305 Southwest H Avenue, Suite #1, Lawton, OK 73501 | 2012-11-21 |
| 1306156989 | Diana Nix | Licensed Practical Nurse | 611 Sw B Ave, Lawton, OK 73501 | 2010-10-15 |
| 1689993214 | Crystal Leday | Physical Therapy Assistant | 602 S.e. Wallock, Lawton, OK 73501 | 2010-05-21 |
| 1457679862 | Gary Dean Gardner | Dentist | 1301 West Gore Blvd, Suite 2, Lawton, OK 73501 | 2010-05-10 |
| 1962729848 | Tayler Gammon | Hearing Instrument Specialist | 423 S.w. C Ave, Lawton, OK 73501 | 2010-04-30 |
| 1932430725 | Eric B Carpenter Sr. | Counselor | 807 Sw F Avenue, Lawton, OK 73501 | 2010-01-19 |
| 1447487640 | Benjamin Llanos | Counselor | 1719 Sw 11th, Lawton, OK 73501 | 2009-06-15 |
| 1710122833 | Provide Hearing Aids | Public Health or Welfare | 1201 West Gore Blvd, Suite D, Lawton, OK 73501 | 2008-12-03 |
| 1053506121 | Mercer Beauty Supply | Orthotic Fitter | 1016 Sw D Ave, Lawton, OK 73501 | 2007-09-11 |
| Find all providers in zip 73501 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700343829 | Paul Gerard Adams | Counselor | 5529 Nw Eisenhower Dr, Lawton, OK 73505-5826 | 2019-02-25 |
| 1790277259 | Powers Powers & Slagle LLC | Counselor | 1930 Nw Ferris Ave Ste 4, Lawton, OK 73507-5629 | 2018-05-31 |
| 1316300429 | Misty Dawn Watkins | Counselor | 2414 Nw Norman Cir, Lawton, OK 73505-1417 | 2016-04-05 |
| 1740665686 | Andrea Vangorder | Counselor | 910 Sw E Ave, Lawton, OK 73501-4593 | 2015-07-21 |
| 1396170791 | Anke Peyton | Counselor | 563 Sunset Dr, Lawton, OK 73507-7164 | 2013-09-05 |
| 1699115139 | Steven Michael Fuller | Counselor | 4202 Sw Lee Blvd., Park Ridge Professional Center, Lawton, OK 73505 | 2013-06-28 |
| 1407193550 | Wanda Denice Smith | Counselor | 2416 Sw Oxford Dr, Lawton, OK 73505-0802 | 2013-01-09 |
| 1083968085 | Doletha Brown | Counselor | 7803 Nw Morrocco Rd, Lawton, OK 73505-1122 | 2012-10-30 |
| 1861742868 | Latoria M Miller | Counselor | 2208 Sw Edinburough Dr, Lawton, OK 73505-0849 | 2012-09-17 |
| 1043575947 | Lillian L Bell | Counselor | 1510 Se Walnut Creek Rd, Lawton, OK 73501-8327 | 2012-07-07 |
| Find all providers in LAWTON | ||||
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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.