| Ms Mary M Noble, | |
|
401 W. Main St., Barnsdall, OK 74002-0000 | |
| (918) 521-6020 | |
| Not Available |
| Full Name | Ms Mary M Noble |
|---|---|
| Gender | Female |
| 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 |
|---|---|---|---|
| 1912318072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| Entity Name | Grand Lake Mental Health Center, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497762520 PECOS PAC ID: 4688711534 Enrollment ID: O20091026000174 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Mary M Noble, 401 W. Main St., Barnsdall, OK 74002-0000 Ph: (918) 521-6020 | Ms Mary M Noble, 401 W. Main St., Barnsdall, OK 74002-0000 Ph: (918) 521-6020 |
Scott Mccleary, LPC CANDIDATE Counselor Medicare: May Accept Medicare Assignments Practice Location: 401 W Main St, Barnsdall, OK 74002 Phone: 918-418-6155 |
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, LPC Counselor Medicare: May Accept Medicare Assignments Practice Location: 401 W. Main St., Barnsdall, OK 74002 Phone: 918-847-3527 Fax: 918-777-9018 |
Michael Steven Backora, Counselor Medicare: Accepting Medicare Assignments Practice Location: 401 W. Main St., Barnsdall, OK 74002 Phone: 918-604-6054 Fax: 918-777-9018 |