Randi Bock
Individual provider Active NPI Mental Health Counselor · Moore, OK
NPI 1982156345 · NPPES record last updated Nov 1, 2016
Key facts
- NPI
- 1982156345
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 908 SW 1St St
Moore, OK 73160-2206 - Phone
- (405) 268-1666
- NPI assigned
- Nov 1, 2016
- 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 | Yes |
Addresses
Primary practice location
908 SW 1St St
Moore, OK 73160-2206
Mailing address
908 SW 1St St
Moore, OK 73160-2206
Phone (405) 268-1666
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2016. 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.