| Vickie Diane Clark, | |
|
10905 Ne 10th St, Midwest City, OK 73130-2209 | |
| (918) 791-1995 | |
| Not Available |
| Full Name | Vickie Diane Clark |
|---|---|
| Gender | Female |
| Speciality | Counselor |
| Location | 10905 Ne 10th St, Midwest City, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760765374 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Entity Name | Alliance Mental Health, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053602649 PECOS PAC ID: 0345670733 Enrollment ID: O20200427002009 |
| Mailing Address | Practice Location Address |
|---|---|
| Vickie Diane Clark, 10905 Nw 10th St., Midwest City, OK 74344 Ph: (918) 791-1995 | Vickie Diane Clark, 10905 Ne 10th St, Midwest City, OK 73130-2209 Ph: (918) 791-1995 |
Mrs. Michelle Lee Gaines, MA, LBP, CCRC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2801 Parklawn Dr Ste 303, Midwest City, OK 73110 Phone: 405-610-3644 Fax: 405-610-3647 | |
Quantae Veales, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8821 Oakridge Dr, Midwest City, OK 73110 Phone: 405-834-7681 | |
Karen Hood, Counselor Medicare: Not Enrolled in Medicare Practice Location: 305 E Kittyhawk Dr, Midwest City, OK 73110 Phone: 985-240-9640 | |
Amelia Fraser, LPC Counselor Medicare: Medicare Enrolled Practice Location: 1200 S Air Depot Blvd Ste O, Midwest City, OK 73110 Phone: 405-931-9811 Fax: 405-561-4095 | |
Candace R Jones, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1390 S Douglas Blvd, Ste 102, Midwest City, OK 73130 Phone: 405-455-5312 Fax: 405-455-5279 | |
Shiela R Williams, LPC-S Counselor Medicare: Not Enrolled in Medicare Practice Location: 1625 Melody Dr, Midwest City, OK 73130 Phone: 405-761-9183 | |
Mr. Damon L Guthery, B.S., M.ED Counselor Medicare: Not Enrolled in Medicare Practice Location: 504 E Cardinal Pl, Midwest City, OK 73130 Phone: 405-615-0706 |