| Stephanie Heaton, | |
|
138 S Main, Afton, OK 74331-1822 | |
| (918) 257-4244 | |
| (918) 257-4247 |
| Full Name | Stephanie Heaton |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 138 S Main, Afton, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730511684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | 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 |
|---|---|
| Stephanie Heaton, 114 W Delaware Ave, Nowata, OK 74048-2601 Ph: (918) 273-1841 | Stephanie Heaton, 138 S Main, Afton, OK 74331-1822 Ph: (918) 257-4244 |
Paula Mantooth, Counselor Medicare: Not Enrolled in Medicare Practice Location: 138 S Main, Afton, OK 74331 Phone: 918-257-4244 Fax: 918-257-4247 | |
Stacey Jameson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 138 S. Main St, Afton, OK 74331 Phone: 918-257-4244 | |
Mrs. Michelle R Clarkson, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 138 South Main Street, Afton, OK 74341 Phone: 918-257-4244 | |
Elizabeth Goodeyon, Counselor Medicare: Not Enrolled in Medicare Practice Location: 138 S Main, Afton, OK 74331 Phone: 918-257-4244 Fax: 918-257-4247 | |
Abbegail Ellis, Counselor Medicare: Not Enrolled in Medicare Practice Location: 504 Mulberry, Afton, OK 74331 Phone: 918-325-1141 | |
Ms. Deborah Evelyn Egerer, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 138 S Main, Afton, OK 74331 Phone: 918-257-4244 Fax: 918-257-4247 | |
Sarah Simpson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 138 S Main, Afton, OK 74331 Phone: 918-257-4244 Fax: 918-257-4247 |