| Frank Dewayne Coolbroth Ii, MBS, LADC, LPC | |
|
300 North Dalton, Valliant, OK 74764 | |
| (580) 933-7031 | |
| (580) 286-5132 |
| Full Name | Frank Dewayne Coolbroth Ii |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 300 North Dalton, Valliant, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477768125 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 754 (Oklahoma) | Primary |
| Entity Name | Choctaw Nation Of Oklahoma |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659347623 PECOS PAC ID: 1759294838 Enrollment ID: O20031106000326 |
| Mailing Address | Practice Location Address |
|---|---|
| Frank Dewayne Coolbroth Ii, MBS, LADC, LPC 1504 Cleveland St, Idabel, OK 74745-8008 Ph: (580) 933-7031 | Frank Dewayne Coolbroth Ii, MBS, LADC, LPC 300 North Dalton, Valliant, OK 74764 Ph: (580) 933-7031 |
Paula Beard, M.S., LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 701 Nation Rd, Valliant, OK 74764 Phone: 580-743-5625 | |
Ms. Dana Francis Nobles, MS, CRC, LPC CANDIDA Counselor Medicare: Medicare Enrolled Practice Location: 300 North Dalton, Valliant, OK 74764 Phone: 580-933-7031 Fax: 580-933-7034 | |
Ms. Gina Diane Rice, RN Counselor Medicare: Not Enrolled in Medicare Practice Location: Rr 2 Box 374-5, Valliant, OK 74764 Phone: 580-212-6366 | |
Mrs. Katheryn Helen Pitts, LPC CANDIDATE Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 N Dalton St, Valliant, OK 74764 Phone: 580-203-3600 | |
Daniel West, Counselor Medicare: Not Enrolled in Medicare Practice Location: 564 Sparrow Rd, Valliant, OK 74764 Phone: 580-933-5286 | |
Jason Baker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 N. Dalton Avenue, Valliant, OK 74764 Phone: 580-933-7031 Fax: 580-933-7034 | |
Sheila Diane Rock, Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 N Dalton St, Valliant, OK 74764 Phone: 580-933-7031 Fax: 580-933-7034 |