Canadian County Collaborative LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CANADIAN COUNTY COLLABORATIVE LLC

Practice address

1703 Professional Cir Ste 201
Yukon, OK 73099-6498

Phone

(405) 805-6203

Fax

(405) 896-4151

NPI assigned

Jun 26, 2020

Organization subpart

No

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

Authorized official

Name

Matt Pierce, LPC, RPTSNPI 1982960100

Title

Therapist

Phone

(405) 805-6203

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matt Wayne Pierce

  • Mental Health Counselor
  • Oklahoma City, OK
  • NPI 1982960100
  NPD Authorized official

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593129600000",
    "number": "1780201798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10616 SW 35TH ST",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730990445",
            "telephone_number": "405-805-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 PROFESSIONAL CIR STE 201",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730996498",
            "telephone_number": "405-805-6203",
            "fax_number": "405-896-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANADIAN COUNTY COLLABORATIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "405-805-6203",
        "authorized_official_credential": "LPC, RPTS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200434450A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Addison Marie Campbell, M.S., CF-SLP
• Randi Briann Campbell, PTA
• Timothy Romandel Campbell
• Lucero Paulina Campos Amador, CPRSS
• Can DO Counseling
• Canadian Valley Anesthesia Services
• Chloe M Canary
• Suzanne R. Cannon, LPC,LADC
• Asialynn Marie Cantrell
• Kayla Carlisle, LPN

• Community/Behavioral Health Agency in Yukon, OK
• Providers in Yukon, 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 Jun 26, 2020; 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.