| Halls Anchor Of Hope | |
|
4416 W Houston St Broken Arrow OK 74012 | |
| (918) 288-0027 | |
| (918) 304-6080 |
| Full Name | Halls Anchor Of Hope |
|---|---|
| Speciality | Counselor |
| Location | 4416 W Houston St, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Amanda K Hall (OWNER) |
| Authorized Official Contact | 9182880027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Halls Anchor Of Hope 4416 W Houston St Broken Arrow OK 74012-4645 Ph: (918) 288-0027 | Halls Anchor Of Hope 4416 W Houston St Broken Arrow OK 74012 Ph: (918) 288-0027 |
| NPI Number | 1235885898 |
|---|---|
| Provider Enumeration Date | 02/22/2022 |
| Last Update Date | 10/03/2024 |
| Certification Date | 10/03/2024 |
| Medicare PECOS PAC ID | 0345777843 |
|---|---|
| Medicare Enrollment ID | O20241223001107 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235885898 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Melana A Ivie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285154377 PECOS PAC ID: 4981132768 Enrollment ID: I20250107002036 |
| Provider Name | Harry G Carver |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790992162 PECOS PAC ID: 8123556818 Enrollment ID: I20250108003337 |
| Provider Name | Jamie L Tyler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457597643 PECOS PAC ID: 4183152226 Enrollment ID: I20250116002560 |
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