Candeeta Joy Oliver
Individual provider Active NPI Counselor · Newcastle, OK
NPI 1154680676 · NPPES record last updated May 27, 2025
Key facts
- NPI
- 1154680676
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 05099 (OK)
- Practice address
- 1804 Comice Dr
Newcastle, OK 73065-6267 - Phone
- (723) 631-6945
- NPI assigned
- May 4, 2012
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05099 | OK | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 05099 | OK | Yes |
Addresses
Primary practice location
1804 Comice Dr
Newcastle, OK 73065-6267
Mailing address
1804 Comice Dr
Newcastle, OK 73065-6267
Phone (572) 363-1694
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200494290B | Medicaid | OK | |
| 200494290A | Medicaid | OK |
Other names
- Candeeta Joy Embrey
Other providers in Newcastle, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2025. 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.