MISS JENNIFER SUSANNE MANTER (NPI# 1851953764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851953764 |
| Entity Type | Individual |
| Full Name | MISS JENNIFER SUSANNE MANTER |
| Credential | PSSR |
| Practice Address |
604 S Walnut St Stillwater OK 74074-4222 |
| Practice Telephone | 4053722202 |
| Practice Fax Number | 4054453780 |
| Mailing Telephone | 4053722202 |
| Mailing Fax Number | 4054453780 |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2019-11-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
604 S WALNUT ST |
| City | STILLWATER |
| State | OK |
| Zip Code | 74074-4222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043330988 | Jessica Enchana Richard | Counselor | 604 S Walnut St, Stillwater, OK 74074-4222 | 2007-03-31 |
| 1386241644 | Garrison Gold | Counselor | 604 S Walnut St, Stillwater, OK 74074-4222 | 2020-10-08 |
| 1861018764 | Amber Dawn Harris | Counselor | 604 S Walnut St, Stillwater, OK 74074-4222 | 2020-06-17 |
| 1649896556 | Kathryn Elizabeth Roesler | Counselor | 604 S Walnut St, Stillwater, OK 74074-4222 | 2020-06-17 |
| 1124642665 | Gina Marie Agnew | Registered Nurse | 604 S Walnut St, Stillwater, OK 74074-4222 | 2020-06-01 |
| 1811511520 | Laryn Burns | Registered Nurse | 604 S Walnut St, Stillwater, OK 74074-4222 | 2020-05-29 |
| 1821610486 | Heather M Macy | Registered Nurse | 604 S Walnut St, Stillwater, OK 74074-4222 | 2020-05-17 |
| 1639791320 | Jean Marie Pettus | Case Manager/Care Coordinator | 604 S Walnut St, Stillwater, OK 74074-4222 | 2020-05-15 |
| 1578184248 | Jessica Sue Terrel | Peer Specialist | 604 S Walnut St, Stillwater, OK 74074-4222 | 2020-05-04 |
| 1104446129 | Meleisha L Dickson | Counselor | 604 S Walnut St, Stillwater, OK 74074-4222 | 2020-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366090680 | Jason K. White, Ph.d., LLC | Psychologist | 807 S. Pine St., Stillwater, OK 74074 | 2019-08-29 |
| 1366095861 | Kelsey Lyn Bigheart | Peer Specialist | 5421 S Deer Trail, Stillwater, OK 74074 | 2019-07-23 |
| 1881256691 | Shelly Lynn Green | Nurse Practitioner | 1321 W. 7th Street, Stillwater, OK 74074 | 2019-07-01 |
| 1811426273 | Judy Catlett | Case Manager/Care Coordinator | 800 E. 6th Str, Stillwater, OK 74074 | 2017-06-08 |
| 1518322296 | Abi Physical Therapy Services | Physical Therapist | 810 S. Walnut Street, Stillwater, OK 74074 | 2015-12-22 |
| 1366833451 | Connecting The Pieces | Case Management | 812 S Walnut, Stillwater, OK 74074 | 2015-02-10 |
| 1790122414 | Airie Flanagan | Doula | 2601 Gregory Ln, Stillwater, OK 74074 | 2013-06-04 |
| 1760720668 | Stillwater Histology LLC | Internal Medicine | 1301 W. 6th St, Suite 106, Stillwater, OK 74074 | 2013-01-28 |
| 1144570565 | Nikkie Jo Dunnigan | Counselor | 2322 W 7th, Stillwater, OK 74074 | 2012-09-13 |
| 1487889952 | Lynn B. Roberts | General Practice | 1321 W 7th St, Stillwater Community Health, Stillwater, OK 74074 | 2009-05-27 |
| Find all providers in zip 74074 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407455892 | Kristen Michelle Stock | Peer Specialist | 804 N Dryden Cir, Stillwater, OK 74075-7108 | 2020-10-18 |
| 1457962722 | Keyata I Wright | Peer Specialist | 2502 N Glenwood Dr, Stillwater, OK 74075-2624 | 2020-08-11 |
| 1639702277 | Tresor Mason | Peer Specialist | 3003 E 4th Ave Unit 22, Stillwater, OK 74074-8366 | 2020-02-21 |
| 1437794542 | Paige Dannette Morse | Peer Specialist | 1009 E Brooke Ave, Stillwater, OK 74075-2907 | 2019-11-12 |
| 1477197267 | Cortney Jackson | Peer Specialist | Sioc 1624 Cimarron Plaza, Stillwater, OK 74075-3467 | 2019-11-05 |
| 1063060630 | John Thomas Jardot | Peer Specialist | 4100 W 19th Ave Apt H104, Stillwater, OK 74074-1610 | 2019-08-27 |
| 1366095861 | Kelsey Lyn Bigheart | Peer Specialist | 5421 S Deer Trail, Stillwater, OK 74074 | 2019-07-23 |
| 1811559354 | Sean Matthew Boehm | Peer Specialist | 3214 E Peachtree Ave, Stillwater, OK 74074-6407 | 2019-07-04 |
| 1205495421 | Caitlyn A Lewis | Peer Specialist | 1624 Cimaron Plaza, Stillwater, OK 74075 | 2019-06-11 |
| 1942808464 | Kayla Dawn Crews | Peer Specialist | 1624 Cimarron Plz, Stillwater, OK 74075-3467 | 2020-10-16 |
| Find all providers in STILLWATER | ||||
| City | STILLWATER |
| Zip Code | 74074 |
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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.