PERSONAL REVOLUTIONS BEHAVIORAL HEALTH SERVICES, LLC (NPI# 1164939765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164939765 |
| Entity Type | Organization |
| Organization Name | PERSONAL REVOLUTIONS BEHAVIORAL HEALTH SERVICES, LLC |
| Practice Address |
6801 S Western Ave Ste 105 Oklahoma City OK 73139-1816 |
| Practice Telephone | 4055502688 |
| Practice Fax Number | 4056193924 |
| Mailing Telephone | 4055502688 |
| Mailing Fax Number | 4056193924 |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2019-08-11 |
| Authorized Official Name | KRYSTAL DAWN HALTOM (OWNER) |
| Authorized Official Telephone | 4055502688 |
| Authorized Official Credential | M.A., LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
6323 | OK | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 2003754400B | 05 | |
| OK | 200781380A | 05 |
| Street Address |
6801 S WESTERN AVE STE 105 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73139-1816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447899778 | First Med Primary Care LLC | Clinic/Center | 1142 Sw 104th St, Oklahoma City, OK 73139 | 2020-01-03 |
| 1205305737 | Transit Medical Team LLC | In Home Supportive Care | 1145 S I-240 Service Rd Ste F, Oklahoma City, OK 73139 | 2018-11-14 |
| 1336621770 | Mayra Edith Solis | Case Manager/Care Coordinator | 6510 S. Western Ave Bldg. 400, Oklahoma City, OK 73139 | 2018-09-01 |
| 1619470184 | Linzi L Stewart, D.o., P.l.l.c. | Obstetrics & Gynecology | 10400 S Western Ave Ste 7, Oklahoma City, OK 73139 | 2018-03-12 |
| 1467970467 | Oklahoma Healthcare Transitions Inc | Home Health | 6803 S Western Ave Ste 400, Oklahoma City, OK 73139 | 2017-08-30 |
| 1841714169 | Gentry Kyler Jones | Case Manager/Care Coordinator | 301 W I240 Service Rd, Oklahoma City, OK 73139 | 2017-07-28 |
| 1437688082 | Jasmine Small | Case Manager/Care Coordinator | 6100 S Walker, Okc, OK 73139 | 2017-06-07 |
| 1689029266 | Swalk Operations, LLC | Skilled Nursing Facility | 315 Sw 80th Street, Oklahoma City, OK 73139 | 2016-05-02 |
| 1225491343 | Elizabeth Pratt | Counselor | 301 Interstate 240 Service Rd, Oklahoma City, OK 73139 | 2016-04-05 |
| 1326418542 | Brittany Elis Walley | Case Manager/Care Coordinator | 8015 S Klein Ave, Oklahoma City, OK 73139 | 2015-09-30 |
| Find all providers in zip 73139 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437758224 | Taylor Christine Clinton | Counselor | 3838 Nw 36th St Ste 300, Oklahoma City, OK 73112-2970 | 2020-10-22 |
| 1518585595 | Twelfth House Wellness LLC | Counselor | 1929 Nw 29th St, Oklahoma City, OK 73106-1019 | 2020-07-07 |
| 1902451040 | Latonyia Yvette Rogers | Counselor | 4001 N Classen Blvd Ste 200, Oklahoma City, OK 73118-2683 | 2019-08-06 |
| 1679139182 | Teresa Ann Larkin | Counselor | 1916 Nw 17th St, Oklahoma City, OK 73106-1804 | 2019-05-10 |
| 1326511767 | Andrea Burton | Counselor | 2724 Plymouth Ln, Oklahoma City, OK 73120-3016 | 2019-01-08 |
| 1659840064 | It Starts With You, Lpc Pllc | Counselor | 200 N Harvey Ave Apt 906, Oklahoma City, OK 73102-4023 | 2018-11-14 |
| 1285143370 | Elizabeth M. Cocke, LLC | Counselor | 1826 Westminster Pl, Oklahoma City, OK 73120-4702 | 2017-09-21 |
| 1003331075 | Oden Counseling, Pllc | Counselor | 3033 Nw 63rd St Ste 151e, Oklahoma City, OK 73116-3634 | 2017-08-10 |
| 1982127395 | Brook Beavers | Counselor | 4045 Nw 64th St Ste 520, Oklahoma City, OK 73116-8608 | 2017-07-18 |
| 1154843811 | Stephanie Morgan Wangler | Counselor | 3601 N Classen Blvd Ste 107, Oklahoma City, OK 73118-3231 | 2017-07-13 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73139 |
Please comment or provide details below to improve the information on PERSONAL REVOLUTIONS BEHAVIORAL HEALTH SERVICES, LLC.
| 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.