Ricardo Gomez-Mendoza, CADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Choctaw, OK

NPI 1669501185 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1669501185
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
14625 NE 23Rd
Choctaw, OK 73020
Phone
(405) 390-8131
Fax
(405) 390-8134
NPI assigned
Mar 2, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-City Youth & Family Center, Inc. Past Accepting new patients
Tri-City Youth & Family Center, Inc. Past Accepting new patients

Specialties & licenses

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

Addresses

Primary practice location

14625 NE 23Rd
Choctaw, OK 73020

Mailing address

PO Box 695
Choctaw, OK 73020-0695
Phone (405) 390-8131

Other providers in Choctaw, OK

All providers in Choctaw, OK · Addiction (Substance Use Disorder) Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.