MS. LISETTE CAVENY (NPI# 1710007067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710007067 |
| Entity Type | Individual |
| Full Name | MS. LISETTE CAVENY |
| Credential | CM-A |
| Practice Address |
109 S Harrill Ave Wagoner OK 74467-5317 |
| Mailing Address |
1001 S Mckinley Ave Wagoner OK 74467-7231 |
| Practice Telephone | 9184853554 |
| Practice Fax Number | 9184858371 |
| Mailing Telephone | 9187980555 |
| Mailing Fax Number | 9184853554 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
109 S HARRILL AVE |
| City | WAGONER |
| State | OK |
| Zip Code | 74467-5317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265049654 | Shayla Ricchele Phillips | Clinic/Center | 109 S Harrill Ave, Wagoner, OK 74467-5317 | 2020-09-29 |
| 1417560988 | Matthew Trent Soldier | Counselor | 109 S Harrill Ave, Wagoner, OK 74467-5317 | 2020-08-25 |
| 1447862578 | Courtney Kristine Sunderland | Social Worker | 109 S Harrill Ave, Wagoner, OK 74467-5317 | 2020-08-19 |
| 1164031704 | Jeremy Vanbrunt | Behavior Technician | 109 S Harrill Ave, Wagoner, OK 74467-5317 | 2020-07-29 |
| 1396363560 | Michael Dean Hutchings | Counselor | 109 S Harrill Ave, Wagoner, OK 74467-5317 | 2020-07-13 |
| 1396360640 | Jordan Marquett Presley I | Counselor | 109 S Harrill Ave, Wagoner, OK 74467-5317 | 2020-06-12 |
| 1730704149 | April C Price | Counselor | 109 S Harrill Ave, Wagoner, OK 74467-5317 | 2020-06-11 |
| 1487278420 | Maeghan Lee Jakubovitz | Counselor | 109 S Harrill Ave, Wagoner, OK 74467-5317 | 2020-06-05 |
| 1164044764 | Ashley M Wood | Counselor | 109 S Harrill Ave, Wagoner, OK 74467-5317 | 2020-05-18 |
| 1003436387 | Dayna Applegate | Case Manager/Care Coordinator | 109 S Harrill Ave, Wagoner, OK 74467-5317 | 2020-04-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982251591 | Alesha Lenard | Behavior Technician | 901 S. Harrill Ave, Wagoner, OK 74467 | 2019-08-20 |
| 1679030597 | Lorri Dawn Pitchford | Case Manager/Care Coordinator | Creoks Behavioral Health Services, 109 S Harrill Ave., Wagoner, OK 74467 | 2019-02-27 |
| 1144769399 | Elaina Murray | Technician | 308 Ne 2nd St., Wagoner, OK 74467 | 2017-02-21 |
| 1336699784 | Tommye Evidson | Counselor | 109 Harrill Ave, Wagoner, OK 74467 | 2016-10-10 |
| 1518327857 | Yco Tulsa, Inc | Clinic/Center | 1101a South Mcquarrie, Wagoner, OK 74467 | 2016-02-29 |
| 1396117545 | Sandra Cooper | Behavioral Analyst | 2109 Us-69, Wagoner, OK 74467 | 2015-10-28 |
| 1588051486 | Penny Nye | Counselor | 2109 S.hwy 69, Wagoner, OK 74467 | 2015-04-20 |
| 1376943571 | Justin F Kurtz | Respiratory Therapist, Certified | 1200 W. Cherokee, Suite H Cardiac/pulmonary Rehab, Wagoner, OK 74467 | 2014-08-26 |
| 1780009969 | David H Good | Family Medicine | 1202 W. Cherokee St, Ste E, Wagoner, OK 74467 | 2014-02-25 |
| 1942598875 | Robin Rodriguez-higginbottom | Speech-Language Pathologist | 215 E Cherokee St, Wagoner, OK 74467 | 2011-07-12 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972118693 | Kenneth Chase Barnett | Student in an Organized Health Care Education/Training Program | 9675 N 25th St E, Wagoner, OK 74467-8733 | 2020-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427897 | Cody Tyson Whatley | Student in an Organized Health Care Education/Training Program | 8725 Anaum Ln, Yukon, OK 73099-3868 | 2020-11-08 |
| 1366043044 | Marielle Crowell | Student in an Organized Health Care Education/Training Program | 700 Nw 51st St, Oklahoma City, OK 73118-6216 | 2020-11-08 |
| 1801497672 | Colton Want | Student in an Organized Health Care Education/Training Program | 833 San Simeon Dr, Edmond, OK 73003-5943 | 2020-11-06 |
| 1952902736 | Brandon Talaro Schmidt | Student in an Organized Health Care Education/Training Program | 100 Ne 4th St Apt 2305, Oklahoma City, OK 73104-2009 | 2020-11-06 |
| 1710588694 | Hayden Mackenzie Bryan | Student in an Organized Health Care Education/Training Program | 1425 Nw 29th St, Oklahoma City, OK 73106-3433 | 2020-11-05 |
| 1548861560 | Cruz Mccarty | Student in an Organized Health Care Education/Training Program | 101 Ne 53rd St Apt 3311, Oklahoma City, OK 73105-1892 | 2020-11-05 |
| 1114528247 | Bradley Taylor | Student in an Organized Health Care Education/Training Program | 808 Carter St Se, Ardmore, OK 73401-8524 | 2020-11-04 |
| 1700487279 | Christopher Michael Hoover | Student in an Organized Health Care Education/Training Program | 1508 Ne 25th St, Moore, OK 73160-8992 | 2020-11-02 |
| 1063013530 | Thomas Labarthe | Student in an Organized Health Care Education/Training Program | 2833 Nw 67th St, Oklahoma City, OK 73116-4612 | 2020-11-02 |
| 1255931739 | Parker Grant Allan | Student in an Organized Health Care Education/Training Program | 5126 E 104th Pl, Tulsa, OK 74137-6082 | 2020-10-26 |
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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.