JACQUE S KOMERS (NPI# 1235657842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235657842 |
| Entity Type | Individual |
| Full Name | JACQUE S KOMERS |
| Practice Address |
6501 N Broadway Ext Suite 180 Oklahoma City OK 73116 |
| Mailing Address |
25518 N 2850 Rd Kingfisher OK 73750 |
| Practice Telephone | 4056074041 |
| Enumeration Date | 2017-09-04 |
| Last Update Date | 2017-09-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 101YS0200X |
Counselor Specialization: School |
Behavioral Health & Social Service Providers | ||
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| N | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
Nursing & Custodial Care Facilities | ||
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
6501 N BROADWAY EXT SUITE 180 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306455068 | Restore Family Counseling, LLC | Clinic/Center | 100 W. Wilshire, Suite #c3, Oklahoma City, OK 73116 | 2020-07-29 |
| 1861058877 | Dental Depot of 63rd & Nw Expressway, Pllc | Clinic/Center | 4025 Nw 63rd Street, Oklahoma City, OK 73116 | 2019-05-15 |
| 1073001756 | Oklahoma Clinical Management LLC | Prevention Professional | 4301 Nw 63rd St Ste 107, Oklahoma City, OK 73116 | 2018-04-27 |
| 1235658261 | Heinen Physical Therapy, PC | Clinic/Center | 7710 N May Ave, Oklahoma City, OK 73116 | 2017-09-11 |
| 1164943874 | Jo Ann Cole-johnson | Counselor | 6505 N. Shawnee Ave, Oklahoma, OK 73116 | 2017-07-03 |
| 1548790793 | Zachary Wayne Skates | Case Manager/Care Coordinator | North 6501 Broadway Extention Highway #180, Oklahoma City, OK 73116 | 2017-06-19 |
| 1548622673 | Jessica Defiore | Case Manager/Care Coordinator | 6501 N Broadway Extension, Oklahoma City, OK 73116 | 2016-03-28 |
| 1093173247 | Patrice Ann Cook | Specialist/Technologist, Other | 7700 N. Hudson Ave, Suite Number 9, Oklahoma City, OK 73116 | 2016-02-03 |
| 1467880708 | Abrina Marie Kneeland | Occupational Therapy Assistant | 6525 N. Meridian #311, Therapists Unlimited Division of Career Staff, Oklahoma City, OK 73116 | 2013-10-24 |
| 1538591649 | Lauren Collier Peterson | Physical Therapist | 7415 N May Ave, Oklahoma City, OK 73116 | 2013-07-31 |
| Find all providers in zip 73116 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073623 | Keonte Criswell | Community/Behavioral Health | 11530 Andover Ct, Oklahoma City, OK 73130-8217 | 2020-11-05 |
| 1730798117 | Healing Minds Counseling LLC | Community/Behavioral Health | 5300 N Meridian Ave Ste 11, Oklahoma City, OK 73112-2179 | 2020-07-30 |
| 1679122287 | New Therapeutic Environment LLC | Community/Behavioral Health | 4301 Nw 63rd St Ste 307, Oklahoma City, OK 73116-1504 | 2019-09-06 |
| 1447808944 | Noahs Ark Aba and Autism Services | Community/Behavioral Health | 14413 S Robinson Ave, Oklahoma City, OK 73170-7233 | 2019-08-28 |
| 1477011195 | Perceptive Counseling Pllc | Community/Behavioral Health | Perceptive Counseling Pllc, 6900 N Classen Blvd, Oklahoma City, OK 73116-7210 | 2019-03-12 |
| 1225594542 | Life Solutions Counseling Agency LLC | Community/Behavioral Health | 6003 N Robinson Ave Ste 102, Oklahoma City, OK 73118-7425 | 2019-02-11 |
| 1083182299 | North Oklahoma County Mental Health Center | Community/Behavioral Health | 4021 S Walker Ave, Oklahoma City, OK 73109-6972 | 2018-11-06 |
| 1649754946 | Kidventures, LLC | Community/Behavioral Health | 1601 Sw 89th St Ste B100, Oklahoma City, OK 73159-6357 | 2018-09-21 |
| 1245710136 | Nexus Solutions for Autism of Oklahoma LLC | Community/Behavioral Health | 405 Nw 30th St, Oklahoma City, OK 73118-8606 | 2018-08-20 |
| 1255854725 | Mission Treatment Centers, Inc. | Community/Behavioral Health | 948 W Hefner Rd, Oklahoma City, OK 73114-6927 | 2017-07-17 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73116 |
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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.