COUNTRYSIDE COUNSELING, PLLC (NPI# 1780235010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780235010 |
| Entity Type | Organization |
| Organization Name | COUNTRYSIDE COUNSELING, PLLC |
| Practice Address |
44038 45th St Shawnee OK 74804-9683 |
| Mailing Address |
32221 Redskin Rd Mcloud OK 74851-8174 |
| Practice Telephone | 4054816683 |
| Mailing Telephone | 4056941462 |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2019-09-27 |
| Authorized Official Name | AMY M BOWEN (OWNER) |
| Authorized Official Telephone | 4056941462 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Countryside Counseling | Doing Business As Name - Organization |
| Street Address |
44038 45TH ST |
| City | SHAWNEE |
| State | OK |
| Zip Code | 74804-9683 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639722804 | Ashlee Tasetano | Occupational Therapist | 44038 45th St, Shawnee, OK 74804-9683 | 2019-07-17 |
| 1740806843 | Katherine Grace Byrne | Occupational Therapist | 44038 45th St, Shawnee, OK 74804-9683 | 2020-06-24 |
| 1821643511 | Shelby Marie Smith | Speech-Language Pathologist | 44038 45th St, Shawnee, OK 74804-9683 | 2019-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164063699 | Isaac Benjamin Gray | Student in an Organized Health Care Education/Training Program | 4010 Blaine Road, Shawnee, OK 74804 | 2019-10-06 |
| 1750863775 | Dillon Gibson | Specialist/Technologist | Oklahoma Baptist University, 500 W. University, Shawnee, OK 74804 | 2018-09-06 |
| 1912368242 | Peggy Baker | Occupational Therapist | 7602 N. Kickapoo, Shawnee, OK 74804 | 2016-03-15 |
| 1861731093 | Shariff Mohammed El-assi | Behavioral Analyst | 45 Crown Point, Shawnee, OK 74804 | 2013-02-07 |
| 1902103112 | Action Physical Therapy & Rehabilitation, Pllc | Physical Therapist | 2506 N Harrison, Shawnee, OK 74804 | 2011-02-24 |
| 1639493315 | Oklahoma Em - 1 Medical Services,p.c. | Emergency Medicine | 1102 W.macarthur, Shawnee, OK 74804 | 2010-03-24 |
| 1790989473 | Eastern Oklahoma Radiation Associates, LLC | Radiology | 3700 N Kickapoo Ave Ste 108, Shawnee, OK 74804 | 2007-06-14 |
| 1821210444 | Mickey Sehorn D.d.s., P.C. | Dentist | 1601 Airport Drive, Shawnee, OK 74804 | 2007-05-03 |
| 1760525711 | Leanna Rae Olsen | Registered Nurse | 1500 N. Kickapoo, Suite #4, Shawnee, OK 74804 | 2007-02-15 |
| 1467517920 | Mahmoud Abdel-fattah Khalifa | Pathology | Unity Health Center, 1102 West Macarthur, Shawnee, OK 74804 | 2006-12-26 |
| Find all providers in zip 74804 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205469616 | Fatemeh Mohammadzadeh | Counselor | 6840 Silverheel St, Shawnee, KS 66226-5300 | 2020-02-14 |
| 1740844968 | Advocates for Change Family Services Pllc | Counselor | 610 N Broadway Ave, Shawnee, OK 74801-6202 | 2019-04-23 |
| 1861884074 | Sara Pounds | Counselor | 600 W Independence St # 900, Shawnee, OK 74804-4320 | 2015-02-25 |
| 1336580281 | Sarah Anne Lake | Counselor | 1127 N. Kickapoo St., Shawnee, OK 74801-4845 | 2013-07-08 |
| 1396185468 | Oscar Mckinley | Counselor | 14921 W 71st Ter, Shawnee, KS 66216-4010 | 2013-07-03 |
| 1023361409 | Kristy Ann Morrell | Counselor | 706 Madeline Dr, Shawnee, OK 74801-6564 | 2012-10-22 |
| 1942503008 | Elizabeth R. Nelson | Counselor | 905 E. Wilson St, Shawnee, OK 74804-3263 | 2010-12-13 |
| 1467782680 | Tammy L Rome | Counselor | 14601 W 61st St, Shawnee, KS 66216-3876 | 2010-01-11 |
| 1982847885 | Stacy Renee Henson | Counselor | 1414 N Kennedy Ave Ste 111, Shawnee, OK 74801-4761 | 2009-04-08 |
| 1649416520 | Toppie Lincicome | Counselor | 2252 Gray Dove, Citizen Potawatomi Nation Clinic 2307 S. Gordon Cooper, Shawnee, OK 74804-2359 | 2008-12-26 |
| Find all providers in SHAWNEE | ||||
Please comment or provide details below to improve the information on COUNTRYSIDE COUNSELING, PLLC.
| 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.