Erica Brady

Individual provider Active NPI Case Manager/Care Coordinator · Grove, OK

NPI 1144702002 · NPPES record last updated Sep 24, 2018

Key facts

NPI
1144702002
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
1115 Harber Rd
Grove, OK 74344-7918
Phone
(918) 786-4434
Fax
(918) 786-4435
NPI assigned
Sep 6, 2018
Sex
Female
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
Grand Lake Mental Health Center, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

1115 Harber Rd
Grove, OK 74344-7918

Mailing address

1115 Harber Rd
Grove, OK 74344-7918
Phone (918) 786-4434

Other providers in Grove, OK

All providers in Grove, OK · Case Manager/Care Coordinator in Oklahoma

Sources for this page

Verify at the official NPI Registry.