CREOKS MENTAL HEALTH (NPI# 1720101439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720101439 |
| Entity Type | Organization |
| Organization Name | CREOKS MENTAL HEALTH |
| Practice Address |
323 W. 6th Street Okmulgee OK 74447 |
| Mailing Address |
4103 S Yale Ave Ste B Tulsa OK 74135-6002 |
| Practice Telephone | 9187569250 |
| Practice Fax Number | 9187562126 |
| Mailing Telephone | 9183827300 |
| Mailing Fax Number | 9183827302 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2019-10-15 |
| Authorized Official Name | MR. BRENT M BLACK (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9187569411 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | 100734620G | OK | Agencies |
| Y | 251S00000X | Community/Behavioral Health | 100734620A | OK | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100734620A | 05 | |
| OK | 100734620G | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528281060 | Creoks Mental Health | Case Management | 209 W. Broadway, Okemah, OK 74859 | 2007-04-11 |
| 1003900267 | Creoks Mental Health | Community/Behavioral Health | 15 E Dewey Ave, Sapulpa, OK 74066-4201 | 2006-10-03 |
| Street Address |
323 W. 6TH STREET |
| City | OKMULGEE |
| State | OK |
| Zip Code | 74447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932718376 | David Louis Holden | Counselor | 1803 W Wood Drive, Okmulgee, OK 74447 | 2020-07-30 |
| 1972097657 | Impact Rehab Consultants | Occupational Therapist | 114 West 7th Street, Okmulgee, OK 74447 | 2018-06-18 |
| 1992192504 | Taquia Bagby | Counselor | 1117 Martin L King Dr., Okmulgee, OK 74447 | 2015-04-21 |
| 1174935886 | Heather Houser | Case Manager/Care Coordinator | 1803 South Wood Drive, Okmuglee, OK 74447 | 2014-05-29 |
| 1376977066 | Anita Kaye Stallings | Case Manager/Care Coordinator | 1018 E 2nd St, Okmulgee, OK 74447 | 2013-08-29 |
| 1013283209 | Megan Breffney Wilson | Family Medicine | 112 West 5th Street, Okmulgee, OK 74447 | 2012-04-01 |
| 1245475466 | Mary Jones | Counselor | 323 W 6th Street, Okmulgee, OK 74447 | 2008-12-03 |
| 1881872182 | State of Oklahoma | Skilled Nursing Facility | 900 E. Airport Rd., Okmulgee, OK 74447 | 2008-02-08 |
| 1053539965 | Shannon Michelle Allison | Physical Therapist | 900 E. Airport Road, Okmulgee, OK 74447 | 2007-04-23 |
| 1023233772 | Ky Joel Kiger | Physical Therapist | 900 East Airport Road, Okmulgee, OK 74447 | 2007-04-16 |
| Find all providers in zip 74447 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639644412 | Shantel Farrow | Community/Behavioral Health | 114 N Grand Ave Ste 212, Okmulgee, OK 74447-4030 | 2018-10-09 |
| 1609164490 | Creoks Behavioral Health Services | Community/Behavioral Health | 1803 S Wood Dr, Okmulgee, OK 74447-6825 | 2011-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073623 | Keonte Criswell | Community/Behavioral Health | 11530 Andover Ct, Oklahoma City, OK 73130-8217 | 2020-11-05 |
| 1427656909 | Against All Odds Youth and Family Services | Community/Behavioral Health | 2701 Nw 185th St, Edmond, OK 73012-9795 | 2020-10-15 |
| 1730798117 | Healing Minds Counseling LLC | Community/Behavioral Health | 5300 N Meridian Ave Ste 11, Oklahoma City, OK 73112-2179 | 2020-07-30 |
| 1477170322 | Glostars LLC | Community/Behavioral Health | 19704 Vivace Dr, Edmond, OK 73012-5232 | 2020-06-26 |
| 1780201798 | Canadian County Collaborative LLC | Community/Behavioral Health | 1703 Professional Cir Ste 201, Yukon, OK 73099-6498 | 2020-06-26 |
| 1235754458 | New Life Counseling Center | Community/Behavioral Health | 1206 N Hwy 81, Duncan, OK 73533-1790 | 2020-06-12 |
| 1770108946 | Meadow Hazelhoff Counseling, LLC | Community/Behavioral Health | 9524 Conners Way, Mcloud, OK 74851-8668 | 2020-06-12 |
| 1407477920 | Keetoowah Economic Development | Community/Behavioral Health | 16414 W 760 Rd, Tahlequah, OK 74464-1675 | 2020-05-06 |
| 1992336481 | Share More Ctc, LLC | Community/Behavioral Health | 2000 N Broadway St Ste B, Moore, OK 73160-4416 | 2020-02-03 |
| 1356981138 | Grand Lake Mental Health Center Inc | Community/Behavioral Health | 2225 N Union, Ponca City, OK 74601-1536 | 2020-01-09 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CREOKS MENTAL HEALTH.
| 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.