Jessica Marie Anderson, LPC/LADC CANDIDATE
Individual provider Active NPI Mental Health Counselor · Mooreland, OK
NPI 1215212170 · NPPES record last updated Oct 11, 2011
Key facts
- NPI
- 1215212170
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 64 (OK)
- Practice address
- 1601 Wilkie Rd
Mooreland, OK 73852-8921 - Phone
- (580) 994-5649
- Fax
- (580) 994-2739
- NPI assigned
- Oct 11, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| White Horse Ranch | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 64 | OK | Yes |
Addresses
Primary practice location
1601 Wilkie Rd
Mooreland, OK 73852-8921
Mailing address
1601 Wilkie Rd
Mooreland, OK 73852-8921
Phone (580) 994-5649
Other providers in Mooreland, OK
All providers in Mooreland, OK · Mental Health 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 Oct 11, 2011. 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.