Amy Renee Gifford, MS LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6682 Issued in OK

Practice address

110 W Maple St
Stilwell, OK 74960-3100

Phone

(918) 708-3006

Fax

(918) 777-9016

NPI assigned

Apr 16, 2018

Last updated

Apr 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grand Lake Mental Health Center, Inc.

  dba Grand Mental Health

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1356048656
  NPD (past)

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1558858522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W MAPLE ST",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "749603100",
            "telephone_number": "918-708-3006",
            "fax_number": "918-777-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W MAPLE ST",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "749603100",
            "telephone_number": "918-708-3006",
            "fax_number": "918-777-9016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIFFORD",
        "first_name": "AMY",
        "middle_name": "RENEE",
        "credential": "MS LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "6682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marquana Fourkiller, LPN
• Ruth Ann Fourkiller
• Matthew Lynn Freeman, PA
• Jericho Garr
• Sarah Elizabeth Garrett
• Debrah J Goff
• Grand Lake Mental Health Center, Inc.
• Jordan Matthew Green
• William Crawford Gregory, PTA
• Tony Grim Grim

• Mental Health Counselor in Stilwell, OK
• Providers in Stilwell, 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 Apr 16, 2018; 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.