EAGLE RIDGE INSTITUTE (NPI# 1790902260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790902260 |
| Entity Type | Organization |
| Organization Name | EAGLE RIDGE INSTITUTE |
| Practice Address |
601 Ne 63rd St Oklahoma City OK 73105-6407 |
| Practice Telephone | 4058401359 |
| Practice Fax Number | 4058587015 |
| Mailing Telephone | 4058401359 |
| Mailing Fax Number | 4058587015 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JINA YOUNG (AREA COORDINATOR) |
| Authorized Official Telephone | 4058401359 |
| Authorized Official Credential | MED, LADC, LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851521363 | Eagle Ridge Institute | Community/Behavioral Health | 109 W 2nd Street, Tahlequah, OK 74464 | 2009-07-17 |
| 1669602173 | Eagle Ridge Institute | Community/Behavioral Health | 1515 W Chickasaw, Sallisaw, OK 74955 | 2009-07-17 |
| 1780801373 | Eagle Ridge Institute | Community/Behavioral Health | 501 E Delaware, Mcalester, OK 74501 | 2007-04-18 |
| 1164544599 | Eagle Ridge Institute | Substance Abuse Rehabilitation Facility | 5427 Easy St, Guthrie, OK 73044-6621 | 2007-04-05 |
| 1396889556 | Eagle Ridge Institute | Community/Behavioral Health | 601 Ne 63rd St, Oklahoma City, OK 73105-6407 | 2007-02-19 |
| 1104182633 | Eagle Ridge Institute | Case Management | 601 Ne 63rd St, Oklahoma City, OK 73105-6407 | 2012-04-10 |
| 1629285267 | Eagle Ridge Institute | Community/Behavioral Health | 109 S Harrill Ave, Wagoner, OK 74467-5317 | 2007-05-16 |
| 1073730545 | Eagle Ridge Institute | Community/Behavioral Health | 601 Ne 63rd St, Oklahoma City, OK 73105-6407 | 2007-04-19 |
| 1821119447 | Eagle Ridge Institute | Community/Behavioral Health | 109 S Harrill Ave, 1, Wagoner, OK 74467-5317 | 2007-04-02 |
| Street Address |
601 NE 63RD ST |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73105-6407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396889556 | Eagle Ridge Institute | Community/Behavioral Health | 601 Ne 63rd St, Oklahoma City, OK 73105-6407 | 2007-02-19 |
| 1851750566 | Stephanie Orner | Psychologist | 601 Ne 63rd St, Oklahoma City, OK 73105-6407 | 2016-02-23 |
| 1972918886 | Anthony Crawford Jr. | Contractor | 601 Ne 63rd St, Oklahoma City, OK 73105-6407 | 2014-06-30 |
| 1104182633 | Eagle Ridge Institute | Case Management | 601 Ne 63rd St, Oklahoma City, OK 73105-6407 | 2012-04-10 |
| 1699047092 | Eagle Ridge | Community/Behavioral Health | 601 Ne 63rd St, Oklahoma City, OK 73105-6407 | 2012-01-31 |
| 1205118783 | Rendy Janssen | Marriage & Family Therapist | 601 Ne 63rd St, Oklahoma City, OK 73105-6407 | 2011-09-12 |
| 1679890867 | Candice Lynn Clinton | Counselor | 601 Ne 63rd St, Oklahoma City, OK 73105-6407 | 2010-04-27 |
| 1063643781 | Heartsong Turnbull | Counselor | 601 Ne 63rd St, Oklahoma City, OK 73105-6407 | 2009-07-29 |
| 1073730545 | Eagle Ridge Institute | Community/Behavioral Health | 601 Ne 63rd St, Oklahoma City, OK 73105-6407 | 2007-04-19 |
| 1912020132 | Marcus L Moore | Case Manager/Care Coordinator | 601 Ne 63rd St, Oklahoma City, OK 73105-6407 | 2007-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730795253 | Darrell Lynn Nowlin | Student in an Organized Health Care Education/Training Program | 4400 North Lincoln Boluvard, Oklahoma City, OK 73105 | 2020-09-21 |
| 1104468834 | Inas Z. Yacoub | Pathology | 921 N.e. 23rd St., Okc, OK 73105 | 2019-10-15 |
| 1861988495 | Grant Weirich | Registered Nurse | 4420 N Lincoln, Oklahoma City, OK 73105 | 2018-07-06 |
| 1073043865 | Joseph W Lee I | Case Manager/Care Coordinator | 2701 N. Oklahoma Ave, Oklahoma City, OK 73105 | 2017-06-14 |
| 1356886840 | Melissa Thompson | Counselor | 4130 N. Lincoln Blvd, Oklahoma City, OK 73105 | 2016-12-20 |
| 1285093484 | Dianne Gray | Student in an Organized Health Care Education/Training Program | 440- N. Lincoln Blvd, Oklahoma City, OK 73105 | 2016-02-16 |
| 1124392600 | Ricki Kelley | Counselor | 330 Ne 59th St., Oklahoma City, OK 73105 | 2012-03-01 |
| 1962770727 | Lakisha Murray | Counselor | 4400 N Lincoln, Oklahoma City, OK 73105 | 2011-12-08 |
| 1760700827 | Deborah Proctor | Counselor | 321 North East 28th, Suite #101, Oklahoma City, OK 73105 | 2010-05-13 |
| 1548588791 | Raganda Washington | Counselor | 321 N.e. 28th, Suite 101, Okc, OK 73105 | 2010-05-12 |
| Find all providers in zip 73105 | ||||
| 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 | 73105 |
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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.