Jessica Tara Dixon-neal, LPC | |
505 S Main St, Porter, OK 74454-1015 | |
(918) 483-0111 | |
Not Available |
Full Name | Jessica Tara Dixon-neal |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 505 S Main St, Porter, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124697511 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 10393 (Oklahoma) | Primary |
Entity Name | Arkansas Verdigris Valley Health Centers, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083740047 PECOS PAC ID: 2961594916 Enrollment ID: O20070822000520 |
Entity Name | Soaak Clinics Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1497592596 PECOS PAC ID: 8426578527 Enrollment ID: O20250219002850 |
Mailing Address | Practice Location Address |
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Jessica Tara Dixon-neal, LPC 1450 Stone Crest Dr, Edmond, OK 73034-6605 Ph: (918) 734-7797 | Jessica Tara Dixon-neal, LPC 505 S Main St, Porter, OK 74454-1015 Ph: (918) 483-0111 |
Mrs. Marjorie Williams Ray, LPC Counselor Medicare: Medicare Enrolled Practice Location: 604 W Finale, Porter, OK 74454 Phone: 918-441-6910 Fax: 918-483-0080 | |
Brandon Udell Bethel, Counselor Medicare: Not Enrolled in Medicare Practice Location: 222 N 6th St, Porter, OK 74454 Phone: 918-310-8775 |