Samantha Nelson
Individual provider Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Wilburton, OK
NPI 1013393438 · NPPES record last updated Aug 7, 2015
Key facts
- NPI
- 1013393438
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Practice address
- 103 1/2 W Main St
Wilburton, OK 74578-4043 - Phone
- (918) 465-7890
- NPI assigned
- Aug 7, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
103 1/2 W Main St
Wilburton, OK 74578-4043
Mailing address
103 1/2 W Main St
Wilburton, OK 74578-4043
Phone (918) 465-7890
Other providers in Wilburton, OK
- Jody McKay
- Medical Supply Solutions, Inc
- Minnie Louise Mitchell
- Gary Nelson
- Lillian Ann Nelson
- Casey Dillon Osterhout
- Osu Center for Health Sciences
- Candice Lynell Ott
- Panola School District 4
- Christi Pollard
All providers in Wilburton, OK · Mental Health Clinic/Center (Including Community Mental Health Center) in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.