| Tara Martin, | |
|
Hc 71 Box 1a, Soper, OK 74759-9721 | |
| (580) 317-5533 | |
| Not Available |
| Full Name | Tara Martin |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | Hc 71 Box 1a, Soper, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922421098 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Entity Name | Serenity Behavioral Services, PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336423086 PECOS PAC ID: 7315353992 Enrollment ID: O20210305000409 |
| Entity Name | Mental Health Specialty Group PA |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801472634 PECOS PAC ID: 8921466228 Enrollment ID: O20240809001257 |
| Entity Name | Brighter Heights Oklahoma LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063576122 PECOS PAC ID: 5294031167 Enrollment ID: O20240819004343 |
| Mailing Address | Practice Location Address |
|---|---|
| Tara Martin, Po Box 102, Bennington, OK 74723-0102 Ph: (580) 317-5533 | Tara Martin, Hc 71 Box 1a, Soper, OK 74759-9721 Ph: (580) 317-5533 |
Martha Gann, Counselor Medicare: Not Enrolled in Medicare Practice Location: Hc 71 Box 75, Soper, OK 74759 Phone: 580-326-3365 |
Rhydonna Gail Linn, LBP Counselor Medicare: Not Enrolled in Medicare Practice Location: Hc 71 Box 1-2, Soper, OK 74759 Phone: 580-326-1221 |