Gina Roselette Childers, B.A.

Primary specialty

CounselorTaxonomy code 101Y00000X

License

NONE Issued in NU

Practice address

109 N Fairland St Ste 101
Pryor, OK 74361-4225

Phone

(918) 825-2884

Fax

(918) 825-2234

NPI assigned

Oct 20, 2009

Last updated

Oct 20, 2009By 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

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts

Practice roles

Locations

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.

• Alliance Mental Health Community Partnership

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Claremore, OK
  • NPI 1679145486
  Medicare reassignment NPD
• Alliance Mental Health, LLC

  dba YCO Alliance

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Claremore, OK
  • NPI 1053602649

  Counselor

  Medicare reassignment NPD
• Alliance Mental Health, LLC.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pryor, OK
  • NPI 1659961530
  NPD
• Alliance Mental Health, LLC

  • Mental Health Counselor
  • Saddle River, NJ
  • NPI 1285520726
  NPD
• Oklahoma Counseling Services, Inc

  dba YouthCare of Oklahoma, Pryor

  • Case Management Agency
  • Pryor, OK
  • NPI 1538178124
  NPD (past)

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255996800000",
    "number": "1760718167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N FAIRLAND ST STE 101",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743614225",
            "telephone_number": "918-825-2884",
            "fax_number": "918-825-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N FAIRLAND ST STE 101",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743614225",
            "telephone_number": "918-825-2884",
            "fax_number": "918-825-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "GINA",
        "middle_name": "ROSELETTE",
        "name_prefix": "Ms.",
        "credential": "B.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": "NONE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Carr
• Carter Healthcare Hospice of North Oklahoma, LLC
• Haley Mae Caveny
• Shelly Lynn Chaudoin, M. ED., CCC-SLP
• Ashley Nicole Chee
• Claremore Pryor Eye Clinic P a
• Natasha K Clark
• Donna C Clifford, REGISTERED NURSE
• Ashley Clover
• Mike Laverne Coatney

• Counselor in Pryor, OK
• Providers in Pryor, OK by specialty
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.