Ronnie E Jestes, C.A.D.C

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Pawnee, OK

NPI 1104042563 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104042563
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
65 (OK)
Practice address
600 Denver St
Pawnee, OK 74058-3522
Phone
(918) 762-3686
Fax
(915) 762-2617
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
United Community Action Program, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 65 OK Yes

Addresses

Primary practice location

600 Denver St
Pawnee, OK 74058-3522

Mailing address

45470 S 349 Rd
Pawnee, OK 74058-1060
Phone (918) 762-3851

Other providers in Pawnee, OK

All providers in Pawnee, OK · Addiction (Substance Use Disorder) Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.