MR. SHELBY O TIDWELL (NPI# 1255658944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255658944 |
| Entity Type | Individual |
| Full Name | MR. SHELBY O TIDWELL |
| Credential | BA, PSRS |
| Practice Address |
1201 Arlington St Ste G Ada OK 74820-4072 |
| Practice Telephone | 5803326851 |
| Practice Fax Number | 5803106047 |
| Mailing Telephone | 5803326851 |
| Mailing Fax Number | 5803106047 |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2010-04-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
1201 ARLINGTON ST STE G |
| City | ADA |
| State | OK |
| Zip Code | 74820-4072 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134314503 | Candy Michelle Hightower | Counselor | 1201 Arlington St Ste G, Ada, OK 74820-4072 | 2007-09-10 |
| 1932749348 | Southern Oklahoma Treatment Serices, Inc. | Community/Behavioral Health | 1201 Arlington St Ste G, Ada, OK 74820-4072 | 2020-01-14 |
| 1669038899 | Danielle Nicole Yu | Case Manager/Care Coordinator | 1201 Arlington St Ste G, Ada, OK 74820-4072 | 2019-05-13 |
| 1508392481 | Victoria Gayle Yates | Behavior Technician | 1201 Arlington St Ste G, Ada, OK 74820-4072 | 2017-05-11 |
| 1720454010 | Jessica Daniel | Case Manager/Care Coordinator | 1201 Arlington St Ste G, Ada, OK 74820-4072 | 2015-08-20 |
| 1356778013 | Alex Marie Thompson | Case Manager/Care Coordinator | 1201 Arlington St Ste G, Ada, OK 74820-4072 | 2013-09-26 |
| 1922433143 | Shelby Manar | Counselor | 1201 Arlington St Ste G, Ada, OK 74820-4072 | 2013-09-06 |
| 1063769248 | James Jeffrey Latham | Counselor | 1201 Arlington St Ste G, Ada, OK 74820-4072 | 2012-08-07 |
| 1184913766 | James Phillip Wood | Counselor | 1201 Arlington St Ste G, Ada, OK 74820-4072 | 2011-04-04 |
| 1508183203 | Melissa Jill Robinson | Counselor | 1201 Arlington St Ste G, Ada, OK 74820-4072 | 2010-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578103727 | Curry Orthopedics and Sports Medicine Pllc | Orthopaedic Surgery | 919 Colony Drive, Ada, OK 74820 | 2020-01-15 |
| 1215574603 | Miranda Denise Bowman | Counselor | 1300 Hoppe Blvd., Suite 5, Ada, OK 74820 | 2019-12-04 |
| 1326509654 | Patricia June Harjo | Case Manager/Care Coordinator | Nittak Himitta' Women's and Children's Recovery Center, 2024 Te Ata Drive, Ada, OK 74820 | 2019-03-28 |
| 1649737172 | Rylee Nikole Leblanc | Case Manager/Care Coordinator | 1119 S High School St, Ada, OK 74820 | 2019-02-20 |
| 1891251328 | David Kinback | Rehabilitation Counselor | 1400 Hoppe Blvd., Suite 3, Cn Recovery Resource Services, Ada, OK 74820 | 2019-02-20 |
| 1922571009 | Central Oklahoma Family Medical Center, Inc. | Pharmacy | 905 Colony Dr, Ada, OK 74820 | 2019-01-10 |
| 1063988673 | Central Oklahoma Family Medical Center, Inc | Clinic/Center | 905 Colony Drive Bldg, Ada, OK 74820 | 2018-10-22 |
| 1265907885 | Apex Surgery Center, LLC | Surgery | 2001 Cradduck Road, Ada, OK 74820 | 2018-10-10 |
| 1689150898 | Sabrina Simmons | Social Worker | 2516 Oakhurst Dr Apt E, Ada, OK 74820 | 2018-07-11 |
| 1700370467 | Brianna Leigh Youngwolfe | Nurse Practitioner | 2020 Arlington St Ste 6, Ada, OK 74820 | 2018-06-17 |
| Find all providers in zip 74820 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588194690 | A Calming Connection-counseling, LLC | Counselor | 14376 County Road 3490 Ada, Ok 74820, 14376 County Road 3490, Ada, OK 74820 | 2017-06-13 |
| 1023468287 | Steven Frank Gostele | Counselor | 510 N Highland St, Ada, OK 74820-4027 | 2016-06-20 |
| 1194105510 | Molly Rose Wilson | Counselor | 7195 Thornapple River Dr Se, Ada, MI 49301-8411 | 2015-06-01 |
| 1093145674 | Tamy Davenport | Counselor | 111 East 12th Street, Ada, OK 74820 | 2013-11-19 |
| 1811339294 | Derick Allen Eidson | Counselor | 19108 County Road 3560, Ada, OK 74820-0177 | 2013-07-25 |
| 1679913362 | Russell Andrew Brown | Counselor | 2036 Ahloso Rd., Ada, OK 74820 | 2013-06-27 |
| 1316281231 | David Hansard | Counselor | Recovery Resource Services, 1300 Hoppe Blvd; Suite 6, Ada, OK 74820 | 2012-11-15 |
| 1578816989 | Donald Cole Gallup | Counselor | 15867 County Road 3619 Loop, Ada, OK 74820-1443 | 2012-10-23 |
| 1598016693 | Diane M Lown | Counselor | 2950 Burwood Hill Ct, Ada, MI 49301-9448 | 2012-09-28 |
| 1982981106 | Joanine Marie Gibson | Counselor | 229 N Hope St, Ada, OK 74820-5228 | 2011-11-16 |
| Find all providers in ADA | ||||
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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.