Panacea Therapy Group, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PANACEA THERAPY GROUP, LLC

Practice address

1015 Waterwood Pkwy Ste G-M1
Edmond, OK 73034-5370

Phone

(405) 513-0282

NPI assigned

Aug 19, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Chad Thomas McCoy, LPCNPI 1346571486

Title

Owner

Phone

(405) 513-0282

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chad McCoy, M.A.

  • Mental Health Counselor
  • Edmond, OK
  • NPI 1346571486
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601683200000",
    "number": "1306458492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 WATERWOOD PKWY STE G-M1",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730345370",
            "telephone_number": "405-513-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 WATERWOOD PKWY STE G-M1",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730345370",
            "telephone_number": "405-513-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANACEA THERAPY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-10-03",
        "certification_date": "2020-10-03",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-513-0282",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Forrest William Paige
• Catherine A Palmer, RD
• Megan Palmer, OTA
• Roberta G Palmer, APRN-FAMILY
• Todd Palmer, LPC
• Rebekah Lauren Panak-Stuart, PHARMD, RPH, MS
• Jayesh Panchal, MD
• Ganga Bhavani Pandaraboyina
• Keshav Panday, MD
• Catherine Anne Panfilio, RD

• Mental Health Counselor in Edmond, OK
• Providers in Edmond, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.