Individual provider Active NPI

Jesse Craighead

  • Counselor
  • Westville, OK
National Provider Identifier
1558722652
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
200534020A Issued in OK
Practice address
747 Highway 59 # 4
Westville, OK 74965-1508
Phone
(918) 723-3757
NPI assigned
Mar 16, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 200534020A OK Primary

Addresses

Primary practice location

747 Highway 59 # 4
Westville, OK 74965-1508

Mailing address

747 Highway 59 # 4
Westville, OK 74965-1508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20231228002139 TX Practitioner - Mental Health Counselor 9638528920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians

Practice addresses (Care Compare)

RR 5 Box
Suite 840
Stilwell, OK 74960-9222
Phone (918) 696-8800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
200534020AOKMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Jan 1, 2024 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Jan 1, 2024 Accepting new patients
Fundamentals Counseling Services,LLC Past Accepting new patients

Locations

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458086400000",
    "number": "1558722652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 HIGHWAY 59 # 4",
            "city": "WESTVILLE",
            "state": "OK",
            "postal_code": "749651508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 HIGHWAY 59 # 4",
            "city": "WESTVILLE",
            "state": "OK",
            "postal_code": "749651508",
            "telephone_number": "918-723-3757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIGHEAD",
        "first_name": "JESSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-16",
        "last_updated": "2016-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "200534020A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westville, OK

Sources for this page

Verify at the official NPI Registry.