BRENDA STACY (NPI# 1356889745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356889745 |
| Entity Type | Individual |
| Full Name | BRENDA STACY |
| Practice Address |
507 Drwey Potesu OK 74953 |
| Practice Telephone | 9186490172 |
| Mailing Telephone | 9186490172 |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-02-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 405300000X | Prevention Professional | 261QM0801X | OK | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871948745 | Brenda Stacy | Counselor | 1403 Metro Dr Ste G, Alexandria, LA 71301-3446 | 2016-04-28 |
| Street Address |
507 DRWEY |
| City | POTESU |
| State | OK |
| Zip Code | 74953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235644550 | Kim Lynn Mcconnell | Case Manager/Care Coordinator | 907 Grace St., Poteau, OK 74953 | 2017-12-08 |
| 1639621451 | Sabrina Danielle Minor | Case Manager/Care Coordinator | 15715 Greentop Road, Poteau, OK 74953 | 2016-10-27 |
| 1902352545 | Daniel Jesse Bruesch | Counselor | 600 Oklahoma Ave., Poteau, OK 74953 | 2016-09-01 |
| 1578912465 | Jo Ann Walden | Counselor | 507 Dewey Avenue, Poteau, OK 74953 | 2016-06-10 |
| 1154708477 | Kendal Repass | Specialist/Technologist | 17100 Nail Creek, Poteau, OK 74953 | 2015-05-06 |
| 1669891768 | Jennifer Branscum | Case Manager/Care Coordinator | 22681 Valley View Rd, Poteau, OK 74953 | 2014-04-16 |
| 1437582145 | Kim Loggains | Counselor | 2104 A-n. Broadway, Poteau, OK 74953 | 2013-08-16 |
| 1457783573 | Derek Morris | Counselor | 3111b N. Broadway St., Box 34, Poteau, OK 74953 | 2013-07-31 |
| 1568743177 | Carol Ann Oliver | Counselor | 34183 Country Club Lane, Poteau, OK 74953 | 2011-09-09 |
| 1881980985 | Hometown Drug Company LLC | Clinic/Center | 307 North Broadway St, Poteau, OK 74953 | 2011-06-27 |
| Find all providers in zip 74953 | ||||
| Taxonomy Code | 405300000X |
| Grouping | Other Service Providers |
| Classification | Prevention Professional |
| Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073001756 | Oklahoma Clinical Management LLC | Prevention Professional | 4301 Nw 63rd St Ste 107, Oklahoma City, OK 73116 | 2018-04-27 |
| 1649703349 | Erica Porter | Prevention Professional | 4760 E 68th St, #267, Tulsa, OK 74136 | 2017-04-10 |
| 1801358791 | Arkansas Clinical Management, LLC | Prevention Professional | 4301 Nw 63rd St Ste 107, Corporate Office, Oklahoma City, OK 73116-1548 | 2019-04-01 |
| 1336610708 | Nancy Lanette Cavner | Prevention Professional | 1011 14th Ave Nw, Ardmore, OK 73401-1828 | 2018-12-11 |
| 1689107070 | Sprouts Child Development Initiative, Inc. | Prevention Professional | 5840 S Memorial Dr Ste 111, Tulsa, OK 74145-9006 | 2017-04-04 |
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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.