JACKIE RENA MOORE (NPI# 1750632782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750632782 |
| Entity Type | Individual |
| Full Name | JACKIE RENA MOORE |
| Credential | BHRS |
| Practice Address |
5721 Oakwood St Spencer OK 73084-8638 |
| Practice Telephone | 4054138416 |
| Mailing Telephone | 4054138416 |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2012-10-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TR0400X |
Psychologist Specialization: Rehabilitation |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629355870 | Jackie Moore | Counselor | 18530 Mack Ave Ste 101, Grosse Pointe, MI 48236-3254 | 2011-11-15 |
| 1710455159 | Jackie L Moore | Adult Companion | 8550 United Plaza Blvd Ste 702, Baton Rouge, LA 70809-0200 | 2018-11-04 |
| 1447746086 | Jackie Ray Moore | Counselor | 200 S Broad St Ste 7, New Orleans, LA 70119-6447 | 2018-07-06 |
| 1285767111 | Jackie Kaye Moore | Registered Nurse | 100 Blythewood Dr, Columbia, TN 38401-4828 | 2007-03-13 |
| Street Address |
5721 OAKWOOD ST |
| City | SPENCER |
| State | OK |
| Zip Code | 73084-8638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891030375 | Ebony Moore | Behavioral Analyst | 5721 Oakwood St, Spencer, OK 73084-8638 | 2012-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740728070 | Tracy Smith | Social Worker | 8507 Ne 47th Street, Spencer, OK 73084 | 2017-02-07 |
| 1316484751 | Marcus Alexander | Case Manager/Care Coordinator | 8226 Ne 26 St, Spencer, OK 73084 | 2017-01-24 |
| 1538589957 | Marcy Thornton | Counselor | #5 Rock N Horse, Spencer, OK 73084 | 2014-04-24 |
| 1710313457 | Janice Kemp | Counselor | 8717 Ne 47th, Spencer, OK 73084 | 2013-09-25 |
| 1629402367 | Robert Benard Smith II | Behavioral Analyst | 8900 Ne 51 St, Spencer, OK 73084 | 2013-08-29 |
| 1508201765 | Marlon T James | Counselor | 3711 Red Bud Dr, Spencer, OK 73084 | 2013-05-01 |
| 1144580341 | Krishaun Jackson | Counselor | 10901 N.e 59th St., Spencer, OK 73084 | 2012-05-22 |
| 1326317074 | Jamie Tyrell Thompson | Behavioral Analyst | 7924 Glory Road, Spencer, OK 73084 | 2011-12-27 |
| 1770860793 | Wendy Jones | Counselor | 8904 N.e 45th St., Spencer, OK 73084 | 2011-11-04 |
| 1114258605 | Florence Yvonne Alexander | Counselor | 12724 Ne 38th, Spencer, OK 73084 | 2010-01-22 |
| Find all providers in zip 73084 | ||||
| Taxonomy Code | 103TR0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750673216 | Tiffany Clevette Black | Psychologist | 3447 Cobblestone Ct, Spencer, OK 73084-3258 | 2011-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982006789 | Jeffrey Johns | Psychologist | 8763 N 97th East Ave Apt 207, Owasso, OK 74055-6864 | 2014-09-23 |
| 1659771996 | Jessica Pendergraft | Psychologist | 615 Amy Dr, Waukomis, OK 73773-1033 | 2014-08-22 |
| 1205249349 | Qiana Hawthorne | Psychologist | 104 Winter Wheat Dr, Guthrie, OK 73044-7750 | 2014-06-06 |
| 1962815902 | Robbin Vanwinkle | Psychologist | 1200 Prairie Heights Dr, Bartlesville, OK 74006-7800 | 2014-06-06 |
| 1275946683 | Silvia De Loera | Psychologist | 1416 Nw 126th St, Oklahoma City, OK 73120-5100 | 2014-06-04 |
| 1306256847 | Jonelle Freeman | Psychologist | 336 E Beech Ave, Enid, OK 73701-1702 | 2014-05-06 |
| 1114337664 | Katelyn James | Psychologist | 2020 Willow Run Ste 100, Enid, OK 73703-1421 | 2014-05-06 |
| 1043638760 | Jana Darnall | Psychologist | 405 N Neshoba St, Tishomingo, OK 73460-1247 | 2014-03-31 |
| 1114344223 | Jordan Harvey | Psychologist | 174 Daniels St, Healdton, OK 73438-1417 | 2014-03-26 |
| 1528489937 | Malerie Guilbeau | Psychologist | 1009 N Birch Ave, Sand Springs, OK 74063-8901 | 2014-01-02 |
| 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.