DR. FAITH LUCILLE PHILLIPS (NPI# 1699925867) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699925867 |
| Entity Type | Individual |
| Full Name | DR. FAITH LUCILLE PHILLIPS |
| Credential | PH.D. |
| Practice Address |
411 S. Park Drive Broken Bow OK 74728 |
| Mailing Address |
411 S. Park Drive Broken Bow OK 74728-3331 |
| Practice Telephone | 5805845550 |
| Practice Fax Number | 8665841223 |
| Mailing Telephone | 5805845550 |
| Mailing Fax Number | 8665841223 |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2018-07-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
513 | OK | Behavioral Health & Social Service Providers |
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
513 | OK | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100837660A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003397571 | Faith Ann Phillips | Registered Nurse | 20928 E Heritage Loop Rd Ste 106, Queen Creek, AZ 85142-3900 | 2018-08-23 |
| Street Address |
411 S. PARK DRIVE |
| City | BROKEN BOW |
| State | OK |
| Zip Code | 74728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104079474 | Faith L. Phillips, Ph.d., Pllc | Psychologist | 411 S. Park Drive, Broken Bow, OK 74728-3331 | 2008-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730732926 | Natorrie D'atra Morris | Nurse Practitioner | Mccurtain Family Medical Clinic, 800 N Park Dr, Broken Bow, OK 74728 | 2019-07-17 |
| 1477925535 | Rebecca Stover | Nurse Practitioner | 813 Veterans Way, Broken Bow, OK 74728 | 2015-10-28 |
| 1023366614 | Tlc Family Clinic, LLC | Clinic/Center | 700 W. Jones, Tlc Family Clinic, LLC, Broken Bow, OK 74728 | 2012-08-29 |
| 1265057251 | Heather Renee Payne | Counselor | 205 N. Main St, Broken Bow, OK 74728 | 2020-06-15 |
| 1396244109 | Erika Ann White | Counselor | 205 N Main St, Broken Bow, OK 74728 | 2018-02-07 |
| 1366954661 | Black Oak Clinic LLC | Clinic/Center | 110 W 1st St, Broken Bow, OK 74728 | 2017-10-26 |
| 1922467505 | Stover Family Clinic | Clinic/Center | 813 Veterans Way, Broken Bow, OK 74728 | 2016-02-11 |
| 1568820140 | Megan Elizabeth Black | Nurse Practitioner | 110 W 1st St, Broken Bow, OK 74728 | 2016-02-10 |
| 1578797221 | Kenneth G Ericksen | Chiropractor | 1605 S Park Dr, Broken Bow, OK 74728 | 2009-05-11 |
| 1629480991 | Renisa Underwood | Case Manager/Care Coordinator | 205 N. Main St, Broken Bow, OK 74728-0000 | 2014-05-21 |
| Find all providers in zip 74728 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104079474 | Faith L. Phillips, Ph.d., Pllc | Psychologist | 411 S. Park Drive, Broken Bow, OK 74728-3331 | 2008-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497111082 | Suzanne Huffman | Psychologist | 601 Vista Ln Trlr 88, Edmond, OK 73034-6329 | 2016-01-12 |
| 1790157394 | Jennifer Lucas Brusich | Psychologist | 5212 E 69th Pl, Tulsa, OK 74136-3407 | 2015-10-22 |
| 1144611336 | Kelly Davis | Psychologist | 9525 S 93rd East Ave, Tulsa, OK 74133-6160 | 2015-02-10 |
| 1558797589 | Blanca A Correa | Psychologist | 344139 E 740 Rd, Agra, OK 74824-8434 | 2013-09-23 |
| 1932546520 | Christina Dawn Willey | Psychologist | 8221 N 117th East Ave, Owasso, OK 74055-2603 | 2013-05-23 |
| 1841423845 | Anne Katherine Jacobs | Psychologist | 515 S Santa Fe Ave, Suite 106, Edmond, OK 73003-6210 | 2009-08-25 |
| 1306016118 | Diane Janice Willis | Psychologist | 4520 Ridgeline Dr, Norman, OK 73072-1729 | 2008-03-07 |
| 1821199217 | Marguerita Lynn Cagle | Psychologist | 10901 E 76th St N, Owasso, OK 74055-3631 | 2006-09-26 |
| 1003856741 | Kelly J Griffith | Psychologist | 1024 W Lakeridge Ave, Stillwater, OK 74075-2106 | 2006-06-08 |
| 1063056737 | Daniel Lawrence Gering | Psychologist | 1212 S Air Depot Blvd Ste 17, Midwest City, OK 73110-4860 | 2019-11-05 |
| Find all providers with the same taxonomy | ||||
| City | BROKEN BOW |
| Zip Code | 74728 |
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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.