Autumn Anthony
Individual provider Active NPI Case Manager/Care Coordinator · Minco, OK
NPI 1760078653 · NPPES record last updated Jun 25, 2024
Key facts
- NPI
- 1760078653
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 408 NW Pontotoc St
Minco, OK 73059-2070 - Phone
- (405) 414-0179
- NPI assigned
- Dec 15, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | OK | ||
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
408 NW Pontotoc St
Minco, OK 73059-2070
Mailing address
408 NW Pontotoc St
Minco, OK 73059-2070
Phone (405) 414-0179
Other providers in Minco, OK
- Allison Nicole Butler
- Compassionate Family Urgent Care LLC
- County of Grady Minco School
- Henry Edward Davis Jr.
- Timilie Deanne Hughes
All providers in Minco, OK · Case Manager/Care Coordinator in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.