WATIE WELLS JR. (NPI# 1568974228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568974228 |
| Entity Type | Individual |
| Full Name | WATIE WELLS JR. |
| Practice Address |
318 N Broadway Ave Shawnee OK 74801-6920 |
| Practice Telephone | 4057023405 |
| Practice Fax Number | 4058420505 |
| Mailing Telephone | 4057023405 |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2017-11-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
318 N BROADWAY AVE |
| City | SHAWNEE |
| State | OK |
| Zip Code | 74801-6920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992073050 | Mary Marguerite Langille-hoppe | Psychologist | 318 N Broadway Ave, Shawnee, OK 74801-6920 | 2011-12-05 |
| 1497182612 | Oklahoma Assessment and Therapy Services | Psychologist | 318 N Broadway Ave, Shawnee, OK 74801-6920 | 2013-10-02 |
| 1699027557 | James Ray Scott | Counselor | 318 N Broadway Ave, Shawnee, OK 74801-6920 | 2012-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538609037 | Melissa Lanier | Specialist | 801 N. Louisa, Shawnee, OK 74801 | 2017-03-02 |
| 1518365287 | Melanie A. Croy | Counselor | 1605 N. Harrison, Shawnee, OK 74801 | 2014-12-12 |
| 1134532229 | Megan Malouf | Registered Nurse | 2307 Gordon Cooper Dr., Shawnee, OK 74801 | 2014-06-05 |
| 1063836609 | Daniel Antwain Shaw | Counselor | 605 S. Pottenger Ave, Shawnee, OK 74801 | 2014-02-18 |
| 1639514862 | Cheryl Jeannette Left Hand | Counselor | 101 N. Union, Shawnee, OK 74801 | 2013-05-01 |
| 1881948644 | Lena I Samilton | Counselor | 319 S. Kennedy Ave., Apt.112, Shawnee, OK 74801 | 2012-11-01 |
| 1235433681 | Jenifer Sloan | Case Manager/Care Coordinator | 2029 S. Gordon Cooper Dr., Shawnee, OK 74801 | 2010-12-28 |
| 1295854958 | Jack C Luman | Dentist | 1410 N Harrison St, Shawnee, OK 74801 | 2007-03-27 |
| 1942375274 | M Gerald Ball | Psychologist | 819 North Kickapoo, Shawnee, OK 74801 | 2006-11-21 |
| 1205912573 | Regina Steciak Tanner | Physical Therapist | 909 N Kickapoo, Shawnee, OK 74801 | 2006-10-31 |
| Find all providers in zip 74801 | ||||
| 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 |
|---|---|---|---|---|
| 1821600164 | Billy Ray Huff Jr. | Peer Specialist | 134 N Philadelphia Ave, Shawnee, OK 74801-7034 | 2020-08-18 |
| 1750905808 | John Howard Davis | Peer Specialist | 540 W Wallace St, Shawnee, OK 74801-5722 | 2020-06-04 |
| 1801345640 | James Franklin Smith Jr. | Peer Specialist | 1919 N Market Ave, Unit B, Shawnee, OK 74804-3644 | 2016-09-21 |
| 1891248605 | Andrea Scraper | Peer Specialist | 1310 Gordon Cooper Dr, Shawnee, OK 74801-8634 | 2016-07-28 |
| 1730706821 | Harrison Blake Hartzell | Peer Specialist | 1010 E 45th St, Shawnee, OK 74804-2202 | 2020-07-06 |
| 1083174353 | Tara Lynn Merritt | Peer Specialist | 1010 E 45th St, Shawnee, OK 74804-2202 | 2019-03-22 |
| 1093292856 | Lindsey Humphrey | Peer Specialist | 110 W 10th St, Shawnee, OK 74801-6804 | 2018-07-24 |
| 1174013767 | Kathleen Jane Madron | Peer Specialist | 101 N Union Ave, Shawnee, OK 74801-7067 | 2018-05-18 |
| 1053831123 | Thomas Riggin Fleming | Peer Specialist | 1010 E 45th St, Shawnee, OK 74804-2202 | 2017-06-21 |
| 1417493214 | Carissa Menefee | Peer Specialist | 1010 E 45th St, Shawnee, OK 74804-2202 | 2017-01-17 |
| Find all providers in SHAWNEE | ||||
Please comment or provide details below to improve the information on WATIE WELLS JR..
| 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.