Gabrielle Evangeline Barnes, MCP, LADC/MH
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Ponca City, OK
NPI 1679096952 · NPPES record last updated Feb 28, 2024
Key facts
- NPI
- 1679096952
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 1421 (OK)
- Practice address
- 200 White Eagle Dr
Ponca City, OK 74601-8315 - Phone
- (580) 762-3421
- NPI assigned
- Jul 19, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240312003965 | OK | Practitioner - Mental Health Counselor | 4688010978 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1421 | OK | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| White Eagle Health Center | Current |
Accepting new patients | |
| White Eagle Health Center | Current |
Accepting new patients | |
| Bridgeway | Case Manager/Care Coordinator | Past |
Accepting new patients |
| White Eagle Health Center | Past | Accepting new patients | |
| Bridgeway, Inc. | Past |
Accepting new patients |
Locations
200 White Eagle Dr
Ponca City, OK 74601
Phone (580) 765-2501
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1421 | OK | Yes |
| Counselor | 101Y00000X | 1421 | OK |
Addresses
Primary practice location
200 White Eagle Dr
Ponca City, OK 74601-8315
Mailing address
620 W Grand Ave
Ponca City, OK 74601-5123
Phone (580) 762-1462
Other providers in Ponca City, OK
- Mary E Bahruth-Poskey
- Lionel Everett Bair II
- Elizabeth Bales
- Lindsey Renee Bales
- Shayla Barber
- Donna Barrows
- Lindsey Bastemeyer
- Renia Lynn Batman
- Gabriel James Beadle
- Francis Dana Bear
All providers in Ponca City, OK · Addiction (Substance Use Disorder) Counselor in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.