OUTDOOR ACHIEVEMENT GROUP, L.L.C. (NPI# 1841787686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841787686 |
| Entity Type | Organization |
| Organization Name | OUTDOOR ACHIEVEMENT GROUP, L.L.C. |
| Practice Address |
5116 N Portland Ave Oklahoma City OK 73112-2077 |
| Mailing Address |
10401 S Trafalgar Dr Oklahoma City OK 73139-5508 |
| Practice Telephone | 4053611754 |
| Practice Fax Number | 4055639511 |
| Mailing Telephone | 4053611754 |
| Mailing Fax Number | 4055639511 |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2018-04-17 |
| Authorized Official Name | JEFFREY L WHITAKER (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 4053611754 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
5116 N PORTLAND AVE |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73112-2077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376553461 | Patricia C. Sullivan | Counselor | 5116 N Portland Ave, Oklahoma City, OK 73112-2077 | 2006-08-09 |
| 1740835255 | Caring Connection Counseling | Counselor | 5116 N Portland Ave, Oklahoma City, OK 73112-2077 | 2019-08-02 |
| 1568927879 | Julia Johnson | Marriage & Family Therapist | 5116 N Portland Ave, Oklahoma City, OK 73112-2077 | 2019-01-31 |
| 1699248666 | Amber Renee Lewis | Counselor | 5116 N Portland Ave, Oklahoma City, OK 73112-2077 | 2019-01-02 |
| 1568943371 | Ewelina Ignaczak | Social Worker | 5116 N Portland Ave, Oklahoma City, OK 73112-2077 | 2018-08-29 |
| 1598242703 | Melissa Kathleen Moseley | Counselor | 5116 N Portland Ave, Oklahoma City, OK 73112-2077 | 2018-07-20 |
| 1871083410 | Kathleen Elizabeth Dawson | Counselor | 5116 N Portland Ave, Oklahoma City, OK 73112 | 2018-05-17 |
| 1083122733 | Kinsey Nicole Bethea | Social Worker | 5116 N Portland Ave, Oklahoma City, OK 73112-2077 | 2018-01-16 |
| 1275051195 | Valli Maloy | Counselor | 5116 N Portland Ave, Oklahoma City, OK 73112-2077 | 2017-08-30 |
| 1164959177 | Megan Beth Schreck | Student in an Organized Health Care Education/Training Program | 5116 N Portland Ave, Oklahoma City, OK 73112-2077 | 2017-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972145886 | Crystopher J Long | Physical Therapist | Parkway Post Acute Recovery Center, 6312 N Portland, Oklahoma City, OK 73112 | 2019-10-11 |
| 1700448974 | Joy Healthcare Services of Okc LLC | Home Health | 4200 Perimeter Center Drive, Suite 125, Oklahoma City, OK 73112 | 2019-07-08 |
| 1801380159 | Crysten Cheatwood Do, PC | Obstetrics & Gynecology | 3433 Nw 56 Street, Suite 210b, Oklahoma City, OK 73112 | 2018-06-20 |
| 1306352521 | Victoria Ann Kappel | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3466 Nw 56th St. Suite 760, Oklahoma City, OK 73112 | 2017-12-26 |
| 1871014886 | Tanesia Michelle Smith | Case Management | 2629 W I44 Service Rd, Suite 202, Oklahoma City, OK 73112 | 2017-06-29 |
| 1619414257 | Edwige Gwanyama | Student in an Organized Health Care Education/Training Program | 2401 Nw 39 Th Expy Ste 103, Oklahoma City, OK 73112 | 2017-01-20 |
| 1619424017 | Jennifer Beaver | Peer Specialist | 2808 Nw 31st, Oklahoma City, OK 73112 | 2016-09-02 |
| 1417305368 | Gabriel Plank | Counselor | 3000 Founders Blvd Suite239, Oklahoma City, OK 73112 | 2016-06-01 |
| 1912364365 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 4101 N May Ave, Oklahoma City, OK 73112 | 2016-01-15 |
| 1679938922 | Portland Anesthesia Associates LLC | Nurse Anesthetist, Certified Registered | 5501 N Porland Ave, Oklahoma City, OK 73112 | 2015-12-30 |
| Find all providers in zip 73112 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306455068 | Restore Family Counseling, LLC | Clinic/Center | 100 W. Wilshire, Suite #c3, Oklahoma City, OK 73116 | 2020-07-29 |
| 1508480872 | Maria Nancy Martinez | Clinic/Center | 5350 S Western Ave Ste 217, Oklahoma City, OK 73109-4525 | 2020-06-03 |
| 1144842923 | Forth Star Counseling LLC | Clinic/Center | 5350 S Western Ave Ste 731, Oklahoma City, OK 73109-4520 | 2020-05-14 |
| 1366082315 | Nourished | Clinic/Center | 10400 Vineyard Blvd Ste B, Oklahoma City, OK 73120-3830 | 2020-01-07 |
| 1750947487 | Counseling and Mediation Services of Oklahoma | Clinic/Center | 13909 Technology Dr, Oklahoma City, OK 73134-1056 | 2019-05-17 |
| 1801366554 | Divine Holistic Intervention Services LLC. | Clinic/Center | 1330 N Classen Blvd Ste 310, Oklahoma City, OK 73106-6834 | 2018-11-26 |
| 1518436518 | Total Care Behavioral Health Services, LLC | Clinic/Center | 5350 S Western Ave Ste 548, Oklahoma City, OK 73109-4536 | 2018-11-19 |
| 1780176479 | Penny Lane Therapy LLC | Clinic/Center | 4416 N Western Ave Ste 207, Oklahoma City, OK 73118-5256 | 2018-05-30 |
| 1134619646 | Anthony Sean Buckley | Clinic/Center | 8018 Nw 87th St, Oklahoma City, OK 73132-3229 | 2018-05-10 |
| 1801396924 | Higher Purpose Counseling Center LLC | Clinic/Center | 6444 Nw Expressway Ste 425d, Oklahoma City, OK 73132-8125 | 2018-02-15 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73112 |
Please comment or provide details below to improve the information on OUTDOOR ACHIEVEMENT GROUP, L.L.C..
| 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.