| Michael Steven Backora, | |
|
401 W. Main St., Barnsdall, OK 74002-6631 | |
| (918) 604-6054 | |
| (918) 777-9018 |
| Full Name | Michael Steven Backora |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 401 W. Main St., Barnsdall, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831602507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Entity Name | Family & Children's Services, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023122439 PECOS PAC ID: 9830170687 Enrollment ID: O20040527000124 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Steven Backora, 401 W. Main St., Barnsdall, OK 74002-6631 Ph: (918) 604-6054 | Michael Steven Backora, 401 W. Main St., Barnsdall, OK 74002-6631 Ph: (918) 604-6054 |
Ms. Shavonne Etolia Taylor, MHR LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 401 W Main St, Barnsdall, OK 74002 Phone: 918-289-0550 Fax: 918-289-0551 | |
Mrs. Jill Suzanne Sago, BA, MED, MHR Counselor Medicare: Not Enrolled in Medicare Practice Location: 401 W. Main St., Barnsdall, OK 74002 Phone: 918-847-3527 | |
Misty Davis, Counselor Medicare: Not Enrolled in Medicare Practice Location: 401 W. Main St., Barnsdall, OK 74002 Phone: 918-847-3527 Fax: 918-777-9018 |