WANDA A BLACKWELL (NPI# 1740350396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740350396 |
| Entity Type | Individual |
| Full Name | WANDA A BLACKWELL |
| Credential | MS, LPC |
| Practice Address |
1131 N Kickapoo Ave Shawnee OK 74801-4845 |
| Mailing Address |
Po Box 3 Morris OK 74445-0003 |
| Practice Telephone | 4052752877 |
| Practice Fax Number | 4052752877 |
| Mailing Telephone | 9187339486 |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2010-02-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | LPC #3140 | OK | Behavioral Health & Social Service Providers |
| Street Address |
1131 N KICKAPOO AVE |
| City | SHAWNEE |
| State | OK |
| Zip Code | 74801-4845 |
| 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 | 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 |
|---|---|---|---|---|
| 1669024790 | Monica Pacheco | Counselor | 429 N Union Ave, Shawnee, OK 74801-7019 | 2019-07-09 |
| 1386101624 | Kelly S Beck | Counselor | 722 E Independence St Ste I, Shawnee, OK 74804-4037 | 2019-02-22 |
| 1700326626 | Heidi Jeffcoat | Counselor | 4404 N Pottenger Ave, Shawnee, OK 74804-1269 | 2017-02-24 |
| 1386199081 | Mindee Todd | Counselor | 600 W Independence St Ste 900, Shawnee, OK 74804-4320 | 2016-08-23 |
| 1679956189 | Sarah Simonson | Counselor | 600 W Independence St, Suite 900, Shawnee, OK 74804-4320 | 2015-07-01 |
| 1972901460 | Greta Morgan | Counselor | 16851 W 67th Ter, Apt. 379, Shawnee, KS 66217-9694 | 2014-12-15 |
| 1518365287 | Melanie A. Croy | Counselor | 1605 N. Harrison, Shawnee, OK 74801 | 2014-12-12 |
| 1487064796 | Amanda Allen | Counselor | 43985 Hunters Hill Dr, Shawnee, OK 74801-8927 | 2014-05-08 |
| 1053734343 | Preston Leon Armstrong | Counselor | 37800 W. Macarthur St, Lot 22, Shawnee, OK 74804-9265 | 2014-01-23 |
| 1205178209 | Melissa Sue Upton-strong | Counselor | 3602 N Union Ave, Shawnee, OK 74804-2158 | 2013-03-18 |
| Find all providers in SHAWNEE | ||||
Please comment or provide details below to improve the information on WANDA A BLACKWELL.
| 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.