CREOKS MENTAL HEALTH SERVICES (NPI# 1730452459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730452459 |
| Entity Type | Organization |
| Organization Name | CREOKS MENTAL HEALTH SERVICES |
| Practice Address |
504 N Broadway Ave Shawnee OK 74801-6927 |
| Mailing Address |
323 W 6th St Okmulgee OK 74447-5019 |
| Practice Telephone | 4052751844 |
| Practice Fax Number | 4052751124 |
| Mailing Telephone | 9187569411 |
| Mailing Fax Number | 9187562126 |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2019-10-15 |
| Authorized Official Name | TABITHA TALBOT (GOHEALTH HELPDESK MANAGER) |
| Authorized Official Telephone | 9183827300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 561 | OK | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100734620 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730712316 | Creoks Mental Health Services | Clinic/Center | 19320 E Admiral Pl Ste B, Catoosa, OK 74015-3240 | 2020-02-21 |
| 1528603198 | Creoks Mental Health Services | Clinic/Center | 186 W Court St, Atoka, OK 74525-1822 | 2019-11-07 |
| 1689219263 | Creoks Mental Health Services | Community/Behavioral Health | 2807 N Broadway St Ste C, Poteau, OK 74953-5557 | 2019-11-07 |
| 1699310276 | Creoks Mental Health Services | Community/Behavioral Health | 4704 Nw Motif Manor Blvd Ste 4, Lawton, OK 73505-4800 | 2019-11-07 |
| 1598316358 | Creoks Mental Health Services | Clinic/Center | 2548 E Kenosha St, Broken Arrow, OK 74014-6712 | 2019-09-24 |
| 1225333826 | Creoks Mental Health Services | Community/Behavioral Health | 716 S 2nd St Ste 101, Stilwell, OK 74960-4806 | 2011-01-13 |
| 1043331499 | Creoks Mental Health Services | Community/Behavioral Health | 711 S Muskogee Ave, Tahlequah, OK 74464-4717 | 2007-04-03 |
| 1841311289 | Creoks Mental Health Services | Community/Behavioral Health | 4103 S Yale Ave Ste B, Tulsa, OK 74135-6002 | 2007-04-03 |
| 1568004232 | Creoks Mental Health Services | Pharmacy | 4103 S Yale Ave Ste B, Tulsa, OK 74135-6002 | 2019-10-14 |
| 1104360692 | Creoks Mental Health Services | Community/Behavioral Health | 203 2nd Ave Sw, Miami, OK 74354-6818 | 2016-12-19 |
| Street Address |
504 N BROADWAY AVE |
| City | SHAWNEE |
| State | OK |
| Zip Code | 74801-6927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639400435 | Darla Gene Lorance | Counselor | 504 N Broadway Ave, Shawnee, OK 74801-6927 | 2010-01-19 |
| 1588003099 | Tywana Reese | Behavioral Analyst | 504 N Broadway Ave, Shawnee, OK 74801-6927 | 2013-06-18 |
| 1467707430 | Karen Anne Hynes | Psychologist | 504 N Broadway Ave, Shawnee, OK 74801-6927 | 2012-07-17 |
| 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 | 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 |
|---|---|---|---|---|
| 1154840247 | Mlc Therapy LLC | Community/Behavioral Health | 6136 King St, Shawnee, KS 66203-2760 | 2017-09-11 |
| 1831594159 | Dannielle Nokes, Msw, Lcsw, Cmiii, LLC | Community/Behavioral Health | 23 E 9th St Ste 301, Shawnee, OK 74801-6962 | 2014-10-29 |
| 1982006607 | Stacey Stephens, Lpc, Pllc | Community/Behavioral Health | 44100 45th St, Shawnee, OK 74804-9432 | 2014-09-24 |
| 1902211782 | Autism Services of Kansas, LLC | Community/Behavioral Health | 6922 Meadowlark Ln, Shawnee, KS 66226-3546 | 2014-06-30 |
| 1831305473 | Soul Care Counseling, LLC | Community/Behavioral Health | 6824 Lackman Rd, Shawnee, KS 66217-9595 | 2007-05-14 |
| 1275158446 | Community Health Centers, Inc. | Community/Behavioral Health | 130 N Broadway Ave Ste 300, Shawnee, OK 74801-6939 | 2020-06-12 |
| 1750704581 | Focus Counseling, LLC | Community/Behavioral Health | 1127 N Kickapoo Ave, Shawnee, OK 74801-4845 | 2014-01-30 |
| 1053741157 | Hope Revealed Behavioral Health Center | Community/Behavioral Health | 2218 N Kickapoo Ave, Shawnee, OK 74804-2703 | 2013-11-26 |
| 1891022539 | Pioneer | Community/Behavioral Health | 23 E 9th St, Suite 444, Shawnee, OK 74801-6943 | 2009-11-17 |
| 1588828420 | Oklahoma Mental Health Council | Community/Behavioral Health | 101 N Union Ave, Shawnee, OK 74801-7067 | 2008-07-10 |
| Find all providers in SHAWNEE | ||||
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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.