Individual provider Active NPI

John Allen Haile, LADC/MH

  • Addiction (Substance Use Disorder) Counselor
  • Claremore, OK
National Provider Identifier
1528343563
Registry record updated Feb 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
12005 E 470 Rd
Claremore, OK 74017-3737
Phone
(918) 342-0770
Fax
(918) 342-0087
NPI assigned
Oct 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

12005 E 470 Rd
Claremore, OK 74017-3737

Mailing address

12005 E 470 Rd
Claremore, OK 74017-3737
Phone (918) 342-0770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240925002130 OK Practitioner - Mental Health Counselor 2860933215 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1270OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Lake Mental Health Center, Inc. CurrentSince Sep 12, 2024 Accepting new patients
Grand Lake Mental Health Center, Inc. CurrentSince Sep 12, 2024 Accepting new patients
Grand Lake Mental Health Center, Inc. Current Accepting new patients

Locations

12005 E 470 Rd
Claremore, OK 74017
Phone (918) 342-0070

3100 Medical Pkwy
Claremore, OK 74017
Phone (918) 341-2356

111 S Treaty Rd
Miami, OK 74354
Phone (918) 540-1511

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

109 N Fairland St
Pryor, OK 74361
Phone (918) 825-1406

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1528343563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12005 E 470 RD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740173737",
            "telephone_number": "918-342-0770",
            "fax_number": "918-342-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12005 E 470 RD",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740173737",
            "telephone_number": "918-342-0770",
            "fax_number": "918-342-0087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAILE",
        "first_name": "JOHN",
        "middle_name": "ALLEN",
        "credential": "LADC/MH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-20",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

Verify at the official NPI Registry.