Jennifer Jean Callahan

Individual provider Active NPI Peer Specialist · Commerce, OK

NPI 1932807690 · NPPES record last updated Feb 21, 2023

Key facts

NPI
1932807690
Entity type
Individual (NPI type 1)
Primary specialty
Peer Specialist 175T00000X
Practice address
304 N Mickey Mantle Blvd
Commerce, OK 74339-1110
Phone
(918) 675-4100
NPI assigned
Feb 21, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Oklahoma Council on Alcoholism, Inc. Past
since Feb 26, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Yes

Addresses

Primary practice location

304 N Mickey Mantle Blvd
Commerce, OK 74339-1110

Mailing address

304 N Mickey Mantle Blvd
Commerce, OK 74339-1110
Phone (918) 675-4100

Other providers in Commerce, OK

All providers in Commerce, OK · Peer Specialist in Oklahoma

Sources for this page

Verify at the official NPI Registry.