Wendy Bohorquez
Individual provider Active NPI Professional Counselor · Nowata, OK
NPI 1124796347 · NPPES record last updated Mar 21, 2024
Key facts
- NPI
- 1124796347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 10497 (OK)
- Practice address
- 325 S Ash St
Nowata, OK 74048-4628 - Phone
- (918) 273-7344
- NPI assigned
- Sep 1, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240914000752 | OK | Practitioner - Mental Health Counselor | 7719427905 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10497 | OK | MD | Psychiatric Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand Lake Mental Health Center, Inc. | Current | Accepting new patients | |
| Grand Lake Mental Health Center Inc | Current |
Accepting new patients | |
| Grand Lake Mental Health Center, Inc. | Current |
Accepting new patients |
Locations
111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511
114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207
325 S Ash St
Nowata, OK 74048
Phone (918) 273-7344
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Professional Counselor | 101YP2500X | 10497 | OK | Yes |
Addresses
Primary practice location
325 S Ash St
Nowata, OK 74048-4628
Mailing address
325 S Ash St
Nowata, OK 74048-4628
Phone (918) 273-7344
Other providers in Nowata, OK
- Samantha Bayles
- Jennifer Grace Beck
- Shelly Bell
- Sierra Ramsie Black
- Jennifer Boer
- Vicki Boren
- Amber Lynn Bracken
- Leah Bradley
- Alexxis Dominique Brown
- Falena Brown
All providers in Nowata, OK · Professional Counselor in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.