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NPI Code Detail

MEDICARE: CREOKS MENTAL HEALTH SEERVICES

MEDICARE: CREOKS MENTAL HEALTH SEERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyCMHC-561OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629341342
Entity Type Code : Organization
Provider Name (Legal Business Name) : CREOKS MENTAL HEALTH SEERVICES
Provider Business Mailing Address
First Line : 4301 SOUTH YALE AVE, STE B
Second Line :
City : TULSA
State : OK
Zip : 74135
Country : US
Telephone Number : 918-382-7300
Fax Number : 918-382-7302
Provider Business Practice Location Address
First Line : 401 S DEWEY AVE STE 108
Second Line :
City : BARTLESVILLE
State : OK
Zip : 74003-3525
Country : US
Telephone Number : 918-336-0810
Fax Number : 918-336-0836
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : MRS. BRANDI SMITH
Credential : LPC
Telephone Number : 918-382-7300
Provider Enumeration Date : 02/10/2012
Last Update Date : 10/11/2019

Similar Medicare Providers

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Practice Location Address:
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Practice Fax:
1699181776 — MRS. LEAH RACHELLE CHUPP LPC
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1528687548 — HAILEY DEANN SMITH
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401 S DEWEY AVE STE 108
BARTLESVILLE, OK
74003-3525
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Practice Fax:
1073194619 — KYLEE KRYSTINE ALMENDAREZ
Practice Location Address:
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1437728433 — SIERRA RENEE SOUTH
Practice Location Address:
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Practice Fax:

Directions to “CREOKS MENTAL HEALTH SEERVICES ” Practice Location

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