MRS. KENNA MARIE WISE (NPI# 1023340643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023340643 |
| Entity Type | Individual |
| Full Name | MRS. KENNA MARIE WISE |
| Credential | LPC |
| Practice Address |
2250 W Modelle Ave A & B Clinton OK 73601-3749 |
| Mailing Address |
110 E Franklin Ave Weatherford OK 73096-5156 |
| Practice Telephone | 5803837609 |
| Mailing Telephone | 5803737609 |
| Enumeration Date | 2010-02-06 |
| Last Update Date | 2015-03-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
3631 | OK | Behavioral Health & Social Service Providers |
| Street Address |
2250 W MODELLE AVE A & B |
| City | CLINTON |
| State | OK |
| Zip Code | 73601-3749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689098394 | Connect Hearing, Inc. | Audiologist | 2250 W Modelle Ave, Ste A, Clinton, OK 73601-3749 | 2014-02-17 |
| 1912228388 | Christopher T. Gregston | Counselor | 2250 W Modelle Ave, Suites A & B, Clinton, OK 73601-3749 | 2010-06-18 |
| 1689906158 | Bridgett Sue Sims | Counselor | 2250 W Modelle Ave, Clinton, OK 73601-3749 | 2010-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225514458 | April Walker | Pharmacist | 100 N. 30th, Clinton, OK 73601 | 2018-07-11 |
| 1477045995 | Dynamic Psychological & Mediation Services | Counselor | 104 S 7th St, Clinton, OK 73601 | 2018-05-31 |
| 1619490851 | Kristyn Wagner | Social Worker | 90 N 31st Street, Clinton, OK 73601 | 2017-07-19 |
| 1124478193 | Lindsay Dlugonski | Nurse Practitioner | 545 S. 30th Street, Clinton, OK 73601 | 2016-06-20 |
| 1881059434 | Cathrine Mears | Counselor | 94 N 31st, Clinton, OK 73601 | 2015-12-28 |
| 1326464603 | Melissa Lucia Torres | Nurse Practitioner | 3140 W. Hayes, Clinton, OK 73601 | 2014-03-11 |
| 1356789341 | Clinton Hmpn, LLC | Family Medicine | 129 S. 9th Street, Clinton, OK 73601 | 2013-06-12 |
| 1881950970 | Namen Bouma | Counselor | 70-100 N. 31st Street, Clinton, OK 73601 | 2012-04-03 |
| 1366717928 | Sherri Lee Milliron | Counselor | 70-100 N 31st, Clinton, OK 73601 | 2012-03-15 |
| 1740597087 | Susan Kathleen Hodges | Counselor | 19 Sunset Place, Clinton, OK 73601 | 2010-09-08 |
| Find all providers in zip 73601 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750478 | Latibbie Cavett | Counselor | 1311 Rosemont Dr, Clinton, MS 39056-3954 | 2020-11-05 |
| 1871136267 | Michael Deshuan Gordon | Counselor | 112 Spanish Moss Dr, Clinton, MS 39056-5838 | 2019-10-18 |
| 1255989117 | Donette Lyn Rotta | Counselor | 6300 Storkson Rd # B2, Clinton, WA 98236-9514 | 2019-09-03 |
| 1235692534 | Mending Broken Bridges Counseling & Consultation, LLC | Counselor | 801 E Northside Dr Ste C, Clinton, MS 39056-3663 | 2019-04-12 |
| 1982171260 | Tanya Vincent | Counselor | 7105 Chickweed Ct, Clinton, MD 20735-5856 | 2018-10-25 |
| 1962926188 | Lashonna Denise Fletcher | Counselor | 201 Kirkwood Dr, Clinton, MS 39056-5970 | 2017-07-29 |
| 1780112268 | Shonda Monique Sessoms | Counselor | 203b Lindale Cir, Clinton, MS 39056-4507 | 2017-05-30 |
| 1295261857 | Well Being Counseling Center LLC | Counselor | 9015 Woodyard Rd Ste 215, Clinton, MD 20735-4209 | 2017-05-02 |
| 1558894428 | Linda Buckmon | Counselor | 5809 Spyri Dr, Clinton, MD 20735-3725 | 2017-04-07 |
| 1467997296 | Janice Hopkins Jr. | Counselor | 420 Rolling Grove Dr, Clinton, MS 39056-2047 | 2017-01-03 |
| Find all providers in CLINTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.