Consulting and Counseling for Community Change, PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

3992 Issued in OK

Legal business name

CONSULTING AND COUNSELING FOR COMMUNITY CHANGE, PLLC

Practice address

2021 Mahaney Ave Ste 4
Tahlequah, OK 74464-5795

Phone

(918) 901-9300

Fax

(918) 901-9339

NPI assigned

Jul 22, 2015

Organization subpart

No

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

Authorized official

Name

Levi Taylor Keehler, MS, LPC, LADC/MHNPI 1386801942

Title

Owner

Phone

(918) 901-9300

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 5

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

• Levi Taylor Keehler, M.S., LPC, LADC, CPS

  • Professional Counselor
  • Tahlequah, OK
  • NPI 1386801942
  Medicare reassignment NPD Authorized official
• Sherry Ann Chennault, M.S., LPC

  • Professional Counselor
  • Tulsa, OK
  • NPI 1033472303
  Medicare reassignment NPD
• Destiny Renee Morse

  • Case Manager/Care Coordinator
  • Tahlequah, OK
  • NPI 1700476868
  NPD
• Melissa Pitts Johnson, MS

  • Professional Counselor
  • Tahlequah, OK
  • NPI 1710376421
  NPD
• Robert V Hensley, D.O.

  • Psychiatry Physician
  • Tahlequah, OK
  • NPI 1831136407
  NPD (past)

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1922483627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 CATHY AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744646609",
            "telephone_number": "918-772-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 MAHANEY AVE STE 4",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744645795",
            "telephone_number": "918-901-9300",
            "fax_number": "918-901-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSULTING AND COUNSELING FOR COMMUNITY CHANGE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-22",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "KEEHLER",
        "authorized_official_first_name": "LEVI",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-901-9300",
        "authorized_official_credential": "MS, LPC, LADC/MH"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "3992",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "606",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Elizabeth Cole, CNM, MSN; FNP
• Zachary Daniel Collett, M.S., ATC, LAT
• Kimberly Jane Collins, MD
• Shawn Ellen Collins
• Mark Alan Combrink, PHARMD
• Kimberley Lee Cook-Vaughn, LADC #624
• Deborah Marie Cookson, PHARM.D.
• Bailey Cooper, ATC
• Micala Cooper
• Tanessa Cooper

• Community/Behavioral Health Agency in Tahlequah, OK
• Providers in Tahlequah, 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 Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.