| Mrs Allie Grantham, MHR, LPC, CADC | |
|
529 N Oak Ave, Tahlequah, OK 74464 | |
| (918) 444-2126 | |
| (918) 458-2300 |
| Full Name | Mrs Allie Grantham |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 11 Years |
| Location | 529 N Oak Ave, Tahlequah, Oklahoma |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447388178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101Y00000X | Counselor | 6374 (Oklahoma) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Northeastern Oklahoma Community Health Centers, Inc | 3678482635 | 32 |
| Entity Name | Northeastern Oklahoma Community Health Centers, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518070481 PECOS PAC ID: 3678482635 Enrollment ID: O20031104000417 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Allie Grantham, MHR, LPC, CADC 31824 E 720 Rd, Wagoner, OK 74467-7374 Ph: (918) 485-9661 | Mrs Allie Grantham, MHR, LPC, CADC 529 N Oak Ave, Tahlequah, OK 74464 Ph: (918) 444-2126 |
Alicia Franke, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1606 E Downing St, Tahlequah, OK 74464 Phone: 918-775-7787 | |
Mr. Chad Alvin Harp, MS ED. Counselor Medicare: Not Enrolled in Medicare Practice Location: 505 Talley St, Tahlequah, OK 74464 Phone: 918-728-1685 | |
Melissa Mccoy, Counselor Medicare: Not Enrolled in Medicare Practice Location: 711 S Muskogee Ave, Tahlequah, OK 74464 Phone: 918-207-0078 | |
Matthew Dennis Wenske, LPC-CANDIDATE Counselor Medicare: Not Enrolled in Medicare Practice Location: 1640 W Keetoowah St, Tahlequah, OK 74464 Phone: 918-708-9009 Fax: 918-708-1714 | |
Bryan R Hooper, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18483 Hilltop Cir, Tahlequah, OK 74464 Phone: 572-247-8015 | |
Sara Howell, Counselor Medicare: Not Enrolled in Medicare Practice Location: 711 S Muskogee Ave, Tahlequah, OK 74464 Phone: 918-207-0078 | |
Terrah Lynn Manes, LCSW Counselor Medicare: Medicare Enrolled Practice Location: 711 S Muskogee Ave, Tahlequah, OK 74464 Phone: 918-207-0078 Fax: 918-207-0558 |