MS. ODETTA MARIA MOORE (NPI# 1689958894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689958894 |
| Entity Type | Individual |
| Full Name | MS. ODETTA MARIA MOORE |
| Practice Address |
5319 S Lewis Ave Suite 210 Tulsa OK 74105-6500 |
| Mailing Address |
12209 East 13th Place Tulsa OK 74128 |
| Practice Telephone | 9186225156 |
| Practice Fax Number | 9186225298 |
| Mailing Telephone | 9184081192 |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2011-10-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Street Address |
5319 S LEWIS AVE SUITE 210 |
| City | TULSA |
| State | OK |
| Zip Code | 74105-6500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346276151 | Stephen O Glenn | Dentist | 5319 S Lewis Ave, Suite 222, Tulsa, OK 74105-6500 | 2006-06-23 |
| 1326685777 | Brandi Kaye Enekweizu | Counselor | 5319 S Lewis Ave, Tulsa, OK 74105 | 2019-12-04 |
| 1457709438 | Justin Michael Young | Dentist | 5319 S Lewis Ave, 222, Tulsa, OK 74105-6500 | 2016-05-31 |
| 1669884565 | Savanah Mcknight | Counselor | 5319 S Lewis Ave, Tulsa, OK 74105 | 2014-05-27 |
| 1417218207 | Melinda Holmes | Counselor | 5319 S Lewis Ave, Tulsa, OK 74105 | 2012-06-07 |
| 1083987853 | Susan Rabinovitz | Counselor | 5319 S Lewis Ave, Tulsa, OK 74105 | 2012-02-09 |
| 1023395548 | Tammy Cook | Counselor | 5319 S Lewis Ave, Tulsa, OK 74105 | 2011-11-11 |
| 1629359880 | Palmer Continuum of Care | Counselor | 5319 S Lewis Ave, Tulsa, OK 74105-6500 | 2011-09-01 |
| 1346562337 | Kristen Nicole Blansett | Counselor | 5319 S Lewis Ave, Tulsa, OK 74105 | 2010-02-18 |
| 1952578981 | Jayme Joyce Woods | Counselor | 5319 S Lewis Ave, Tulsa, OK 74105 | 2008-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881208817 | Op Pharmacy LLC | Pharmacy | 2865 E. Skelly Dr., Ste 225, Tulsa, OK 74105 | 2020-09-08 |
| 1114560554 | Secure Interpretation, LLC | Neurological Surgery | 5561 South Lewis Ave, Tulsa, OK 74105 | 2019-10-17 |
| 1629547286 | Kealey Jordan Oliver | Occupational Therapist | 3223 E. 31st Steet, Tulsa, OK 74105 | 2018-11-13 |
| 1265915631 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3516 S Peoria Ave, Tulsa, OK 74105 | 2018-09-12 |
| 1235635277 | Brenda Kay Sanders | Speech-Language Pathologist | 4911 S Detroit Ave, Tulsa, OK 74105 | 2018-03-30 |
| 1417400771 | Caroline Hunter Heineck | Speech-Language Pathologist | 3223 E. 31st St., Tulsa, OK 74105 | 2016-08-03 |
| 1437509544 | Reliance Care Health Services LLP | Home Health | 5810 S. Peoria Avenue, Tulsa, OK 74105 | 2016-06-20 |
| 1578921748 | Latisha Henderson | Case Manager/Care Coordinator | 3015 E. Skelly Drive, Suite 103, Tulsa, OK 74105 | 2016-02-03 |
| 1326424573 | Evelyn J Fennell | Nurse's Aide | 1143 E 57th Place, Tulsa, OK 74105 | 2015-08-10 |
| 1255717757 | Rebecca Ann Hughes | Dentist | 3150 E 41st St Ste 131, Tulsa, OK 74105 | 2015-08-06 |
| Find all providers in zip 74105 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093328346 | Kathryn Glover Bishop | Counselor | 5921 E 97th St, Tulsa, OK 74137-5011 | 2020-08-26 |
| 1386291425 | Richard Carroll Wheat | Counselor | 5536 E 106th Pl, Tulsa, OK 74137-7089 | 2019-08-22 |
| 1235797747 | Better | Counselor | 301 W 63rd Ct N, Tulsa, OK 74126-1449 | 2019-05-30 |
| 1538634654 | Prevailing Passions Counseling | Counselor | 10212 E 41st St, Tulsa, OK 74146-3703 | 2018-10-04 |
| 1629552971 | Carole's Hope | Counselor | 7711 E 111th St Ste 116, Tulsa, OK 74133-2563 | 2018-09-22 |
| 1174015598 | Debra Anne Beasley | Counselor | 1619 E. 13th St., Tulsa, OK 74120 | 2018-06-01 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1164945820 | Maria Adeshina | Counselor | 2027 N Martin Luther King Jr Blvd, Tulsa, OK 74106-6419 | 2017-07-24 |
| 1841730579 | Bowden Mcelroy and Associates, LLC | Counselor | 7136 S Yale Ave, Tulsa, OK 74136-6373 | 2017-02-28 |
| 1063960094 | Joanna Majka | Counselor | 5550 S Lewis Ave, Suite 301, Tulsa, OK 74105-7118 | 2016-09-19 |
| Find all providers in TULSA | ||||
Please comment or provide details below to improve the information on MS. ODETTA MARIA MOORE.
| 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.