MRS. TINA JEAN FULLER (NPI# 1518294693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1518294693 |
Entity Type | Individual |
Full Name | MRS. TINA JEAN FULLER |
Credential | MS LADC/US |
Practice Address |
1101 E Monroe Ave Mcalester OK 74501-4815 |
Mailing Address |
3751 Wayside Ln Mcalester OK 74501-7643 |
Practice Telephone | 9184267800 |
Mailing Telephone | 9183291476 |
Enumeration Date | 2009-11-10 |
Last Update Date | 2010-10-18 |
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) |
UNDER SUPERVISON | OK | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831688480 | Tina Michele Fuller | Social Worker | 2412 Nw 6th St, Lawton, OK 73507-2211 | 2018-05-08 |
1659879096 | Tina Fuller | Licensed Practical Nurse | 340 S Broadview St, Cape Girardeau, MO 63703-5703 | 2018-01-31 |
Street Address |
1101 E MONROE AVE |
City | MCALESTER |
State | OK |
Zip Code | 74501-4815 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982666582 | Kim L Kurvink | Family Medicine | 1101 E Monroe Ave, Mcalester, OK 74501-4815 | 2006-04-06 |
1194323212 | Martha Grantham | Counselor | 1101 E Monroe Ave, Mcalester, OK 74501-4815 | 2020-10-12 |
1932714334 | Nicole A Young | Peer Specialist | 1101 E Monroe Ave, Mcalester, OK 74501-4815 | 2020-09-11 |
1871101675 | Anthony Campana | Peer Specialist | 1101 E Monroe Ave, Mcalester, OK 74501-4815 | 2020-07-17 |
1861000721 | Amanda Harris | Counselor | 1101 E Monroe Ave, Mcalester, OK 74501-4815 | 2020-07-16 |
1801413729 | Robert Apala | Case Manager/Care Coordinator | 1101 E Monroe Ave, Mcalester, OK 74501-4826 | 2020-06-26 |
1083230080 | Morrison Kate Huffstutlar | Case Manager/Care Coordinator | 1101 E Monroe Ave, Mcalester, OK 74501-4815 | 2020-06-25 |
1154943611 | Augusta Pennington | Peer Specialist | 1101 E Monroe Ave, Mcalester, OK 74501-4815 | 2020-05-07 |
1609496785 | Alana Mattioda | Registered Nurse | 1101 E Monroe Ave, Mcalester, OK 74501-4815 | 2020-04-20 |
1356960645 | Brandi Kay Seawright | Counselor | 1101 E Monroe Ave, Mcalester, OK 74501-4815 | 2020-04-16 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295371466 | Belfair of Mcalester LLC | Assisted Living Facility | 802 Windsong Way, Mcalester, OK 74501 | 2019-11-22 |
1912425018 | Jennifer Bird | Case Manager/Care Coordinator | 34 Harpoon Dr, Mcalester, OK 74501 | 2017-09-08 |
1073033502 | Natalie Aline Kitchell | Case Manager/Care Coordinator | 1303 Hickory Bend, Mcalester, OK 74501 | 2017-06-26 |
1265964308 | Phoenix Counseling and Assessment Center, Inc. | Community/Behavioral Health | 32 E Cherokee, Suite 104, Mcalester, OK 74501 | 2017-03-29 |
1215302799 | Christine Herron | Physical Therapy Assistant | 1029 E. Washington Ave, Mcalester, OK 74501 | 2015-12-09 |
1437538212 | Lauren White | Speech-Language Pathologist | 205 South 2nd, Mcalester, OK 74501 | 2015-05-26 |
1316344096 | Ashley Brooke Monks | Speech-Language Pathologist | 557 Broken Feather Lane, Mcalester, OK 74501 | 2014-11-25 |
1821407644 | William Joseph Kinderknecht | Family Medicine | 4 E. Clark Bass Blvd., Suite 301a, Mcalester, OK 74501 | 2014-08-06 |
1467795153 | Kensey Mckay Holman | Occupational Therapist | 903 E Monroe Ave Ste 200, Mcalester, OK 74501 | 2013-04-01 |
1821334418 | Delors J Simmons | Counselor | 600 North D St, Mcalester, OK 74501 | 2012-12-31 |
Find all providers in zip 74501 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750686002 | Alice Rane' Beckham | Counselor | 1024 W Brewer Ave, Mcalester, OK 74501-2063 | 2011-01-18 |
1215247960 | Rachel Long | Counselor | 805 W. Jackson, Mcalester, OK 74501 | 2010-10-15 |
1407092448 | Albert Thomas | Counselor | 501 Quail Dr, Mcalester, OK 74501-7369 | 2008-12-22 |
1518103613 | William Mcgregor | Counselor | 6007 Walnut Glen Ln, Mcalester, OK 74501-8354 | 2008-12-20 |
1114136314 | William Frank Stovall | Counselor | 32 E Cherokee Ave Ste 104, Mcalester, OK 74501-5323 | 2007-05-22 |
1124247697 | Janine Linda Mangrum | Counselor | 1210 N West St, Mcalester, OK 74501-2306 | 2007-04-24 |
1174748917 | Southeastern Oklahoma Social Services Inc. | Counselor | 512 E Chickasaw Ave, Mcalester, OK 74501-5354 | 2007-04-16 |
1225664329 | Aj Thomason | Counselor | 628 E Creek Ave, Mcalester, OK 74501-6930 | 2020-03-20 |
1275170490 | Danielle Kalyn Bowers | Counselor | 628 E Creek Ave, Mcalester, OK 74501-6930 | 2019-12-06 |
1578090080 | Kourtnee Anderson | Counselor | 628 E Creek Ave, Mcalester, OK 74501-6930 | 2017-05-15 |
Find all providers in MCALESTER |
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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.