MARTI LEEANN NICHOLS (NPI# 1538495692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538495692 |
| Entity Type | Individual |
| Full Name | MARTI LEEANN NICHOLS |
| Credential | LBHP |
| Practice Address |
205 S Adair St Pryor OK 74361-5201 |
| Mailing Address |
308 S Whitaker St Pryor OK 74361-3424 |
| Practice Telephone | 9188254872 |
| Mailing Telephone | 9188640353 |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2012-10-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
OK | Behavioral Health & Social Service Providers | |
| N | 103TR0400X |
Psychologist Specialization: Rehabilitation |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200375130A | 05 |
| Street Address |
205 S ADAIR ST |
| City | PRYOR |
| State | OK |
| Zip Code | 74361-5201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548469380 | Garry Wayne Russell | Counselor | 205 S Adair St, Pryor, OK 74361-5201 | 2007-07-12 |
| 1023535770 | Paul Dean Mcfarland | Peer Specialist | 205 S Adair St, Pryor, OK 74361-5201 | 2017-08-24 |
| 1265854475 | Tracie Stone | Case Manager/Care Coordinator | 205 S Adair St, Pryor, OK 74361-5201 | 2014-01-08 |
| 1588808109 | Pushmataha Counseling Services, Inc. | Community/Behavioral Health | 205 S Adair St, Pryor, OK 74361-5201 | 2009-04-27 |
| 1760682439 | Kelli Anderson | Counselor | 205 S Adair St, Pryor, OK 74361-5201 | 2007-07-20 |
| 1710187711 | James Keith Schardein II | Counselor | 205 S Adair St, Pryor, OK 74361-5201 | 2007-07-19 |
| 1508065970 | Pushmataha Counseling Services, Inc. | Community/Behavioral Health | 205 S Adair St, Pryor, OK 74361-5201 | 2007-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740787928 | Ahs Pryor Hospital, LLC | Clinic/Center | 1301 Ne 1st St Ste 400, Pryor, OK 74361 | 2018-04-12 |
| 1073029310 | Amber Bowman | Registered Nurse | 109 N. Fairland, Pryor, OK 74361 | 2017-12-22 |
| 1922361096 | Crystal Noel Parrett | Counselor | 215 N. Fairland, Pryor, OK 74361 | 2012-06-22 |
| 1447516703 | Rocky Mountain Holdings LLC | Ambulance | 591 Airport Rd, Pryor, OK 74361 | 2012-04-11 |
| 1356673180 | Tressa Fern Rice | Speech-Language Pathologist | 510 S. Elliott St. Suite C, Mayes County Speech Therapy, Pryor, OK 74361 | 2010-02-04 |
| 1083945208 | Ladena Carol Moore | Counselor | 212 S E 1st, Pryor, OK 74361 | 2010-01-28 |
| 1164753323 | Anita K Sanders | Counselor | 212 Se 1st, Pryor, OK 74361 | 2010-01-27 |
| 1619203775 | Sandra Kay Runnells | Psychologist | 109 South Fairland, Suite 101, Pryor, OK 74361 | 2009-10-26 |
| 1972838969 | Ramona L Whitehurst | Advanced Practice Midwife | 1400 Willow Road, Pryor, OK 74361 | 2009-10-08 |
| 1396971297 | Shauna Leann Jackson | Speech-Language Pathologist | 510 S. Elliott, Suite C, Pryor, OK 74361 | 2009-06-05 |
| Find all providers in zip 74361 | ||||
| Taxonomy Code | 103TA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083254932 | Purpose Healthcare Inc | Psychologist | 301 South Blvd, Suite 117, Edmond, OK 73034 | 2020-01-08 |
| 1245636497 | Elisabeth Pitts | Psychologist | 301 W Maine Ave, Enid, OK 73701-5673 | 2014-11-17 |
| 1114339348 | John Walls | Psychologist | 2012 North Villa Avenue, Oklahoma City, OK 73107 | 2014-05-22 |
| 1013347988 | Bradford Don Holinsworth | Psychologist | 2009 S Cherokee Pl, Claremore, OK 74019-3538 | 2013-11-13 |
| 1356683387 | Darryn K Herron I | Psychologist | 5641 S 88th East Ave, Tulsa, OK 74145-7905 | 2013-03-15 |
| 1679811624 | Rashawn T Mance | Psychologist | 2609 Featherstone Rd, Apt 408, Oklahoma City, OK 73120-2105 | 2013-01-26 |
| 1598069031 | Cynthia Ann Barker | Psychologist | 3300 Nw 56th St Ste 220, Oklahoma City, OK 73112-4401 | 2010-12-24 |
| 1144431016 | Helen Lee Veach | Psychologist | 35962 Ew 1300, Seminole, OK 74868-5870 | 2007-05-24 |
| 1508425042 | Samantha Danielle Price | Psychologist | 921 Ne 13th St # 116a, Oklahoma City, OK 73104-5007 | 2019-06-09 |
| 1518458439 | Walter E Cooper | Psychologist | 1215 Nw 25th St, Oklahoma City, OK 73106-5629 | 2018-05-25 |
| 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.