| Shemaiah Davis, LPC | |
|
1015 W Washbourne St, Jay, OK 74346-4205 | |
| (918) 308-5513 | |
| (918) 253-6645 |
| Full Name | Shemaiah Davis |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 1015 W Washbourne St, Jay, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619448263 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | 12185 (Oklahoma) | Primary |
| 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 |
|---|---|
| Shemaiah Davis, LPC 1015 W Washbourne St, Jay, OK 74346-4205 Ph: (918) 308-5513 | Shemaiah Davis, LPC 1015 W Washbourne St, Jay, OK 74346-4205 Ph: (918) 308-5513 |
Ms. Mary Kristina Chance, LADC, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 2485 N Main St, Jay, OK 74346 Phone: 918-253-2550 Fax: 918-253-2122 | |
Elizabeth A Mai, LPC-C Counselor Medicare: Not Enrolled in Medicare Practice Location: 859 E Melton Dr, Jay, OK 74346 Phone: 918-253-1700 Fax: 918-253-4938 | |
Mr. Chad Irvin York, Counselor Medicare: Not Enrolled in Medicare Practice Location: 33200 S 625 Rd, Jay, OK 74346 Phone: 918-418-9185 | |
Aaron Michael Dorland, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1015 W Washbourne St, Jay, OK 74346 Phone: 918-519-4968 | |
Dale L Mcfarland, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1015 W Washbourne St, Jay, OK 74346 Phone: 918-261-7139 |