JENNIE PRUITT (NPI# 1720349327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720349327 |
| Entity Type | Individual |
| Full Name | JENNIE PRUITT |
| Practice Address |
747 Highway 59 Ste 4 Westville OK 74965 |
| Mailing Address |
747 Highway 59 Ste 4 Westville OK 74965-1508 |
| Practice Telephone | 4792209857 |
| Mailing Telephone | 4792209857 |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2018-08-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 711 S Muskogee Ave, Tahlequah, OK 744644717 | 9182070078 |
| Street Address |
747 HIGHWAY 59 STE 4 |
| City | WESTVILLE |
| State | OK |
| Zip Code | 74965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790348522 | Pain Management of Westville | Anesthesiology | 419 S Williams Avenue, Westville, OK 74965 | 2019-04-17 |
| 1689176398 | Molly Elizabeth Murphey | Nurse Practitioner | 605 Buffington Rd, Westville, OK 74965 | 2018-03-08 |
| 1639688237 | Twila W Coates | Case Manager/Care Coordinator | 1000 Taft Street, Westville, OK 74965 | 2017-09-26 |
| 1487195376 | Pam Thurber | Technician, Other | 500 N Chincapin, Westville, OK 74965 | 2017-03-13 |
| 1134577570 | Misty Brown | Technician, Other | 500 West Chincapin, Westville, OK 74965 | 2016-05-26 |
| 1073960738 | Melanie Green | Technician, Other | 500 W Chincapin, Westville, OK 74965 | 2016-05-23 |
| 1497102149 | Dalaina Kristin Smart | Technician, Other | 500 W. Chincapin St., Westville, OK 74965 | 2016-05-23 |
| 1306168844 | Amy Rusk | Counselor | 747 Hwy 59 #4, Westville, OK 74965 | 2010-02-25 |
| 1043493992 | Community Physicians Group | Family Medicine | 419 S Williams, Westville, OK 74965 | 2007-12-14 |
| 1649324880 | Westville Prescription Center Inc | Durable Medical Equipment & Medical Supplies | 301 S Williams, Westville, OK 74965 | 2007-01-23 |
| Find all providers in zip 74965 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750742755 | Christiana Tackie | Counselor | 137 Florence Ave, Westville, NJ 08093-2021 | 2016-03-18 |
| 1306168844 | Amy Rusk | Counselor | 747 Hwy 59 #4, Westville, OK 74965 | 2010-02-25 |
| 1558722652 | Jesse Craighead | Counselor | 747 Highway 59 # 4, Westville, OK 74965-1508 | 2016-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039517 | Tommy Craig Smith | Counselor | 3601 N Classen Blvd Ste 102, Oklahoma City, OK 73118-3231 | 2020-09-29 |
| 1881200558 | Nichole Rae Krausch | Counselor | 1507 S Mckenna St, Poteau, OK 74953-5207 | 2020-09-18 |
| 1467068098 | Mckenzie Mcguffee | Counselor | 717 Briarcrest Dr, Midwest City, OK 73110-1619 | 2020-09-18 |
| 1629683727 | Mason Counseling Services | Counselor | 12718 E 77th Pl N, Owasso, OK 74055-7938 | 2020-09-15 |
| 1437761004 | Ashley Jane Runnells | Counselor | 4867 S Sheridan Rd Ste 712a, Tulsa, OK 74145-5721 | 2020-08-17 |
| 1982214292 | Tera Dee Robbins | Counselor | 1002 Cambell Street, Warner, OK 74469 | 2020-08-03 |
| 1619587946 | Chelsey S Kopaddy | Counselor | 1108 Nw Elm Ave, Lawton, OK 73507-4607 | 2020-08-02 |
| 1932718376 | David Louis Holden | Counselor | 1803 W Wood Drive, Okmulgee, OK 74447 | 2020-07-30 |
| 1043829278 | Tracy Nanette Mckeown | Counselor | 1777 S Yukon Pkwy, Yukon, OK 73099-4599 | 2020-07-23 |
| 1063039915 | Sarah Nicole Hawthorne | Counselor | 12834 S Old Highway 169, Oologah, OK 74053-3333 | 2020-06-26 |
| 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.