Convalesce

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

5734 Issued in OK

Legal business name

CONVALESCE

Practice address

626 N Broadway St
Moore, OK 73160-4814

Phone

(405) 430-8917

NPI assigned

Apr 25, 2016

Last updated

Apr 25, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christiane Lange, MS/LPC

Title

Clinical Director

Phone

(405) 430-8917

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1639524994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 N BROADWAY ST",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731604814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 N BROADWAY ST",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731604814",
            "telephone_number": "405-430-8917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVALESCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-25",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "LANGE",
        "authorized_official_first_name": "CHRISTIANE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "405-430-8917",
        "authorized_official_credential": "MS/LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "5734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Ryleigh Collins, LMSW
• Bridgett Leona Comer
• Ashley Paige Condit, PT
• Kayley Condit
• Ashley Constable, LPC
• Amanda Dawn Cook, LCSW
• Heathere Cooper
• Linda W Cooper, OTR/L
• Brandi Rhea Kelly Copeland, MED, LPC, CADC
• Saharra Copeland

• Community/Behavioral Health Agency in Moore, OK
• Providers in Moore, OK by specialty
• Community/Behavioral Health Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.