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JACALYN R TIDWELL
NPI 1093316457
Peer Specialist in Tulsa, OK

Active since November 03, 2020
5310 E 31ST ST STE 600, TULSA, OK 74135(918) 587-9471 Get Directions Write a Review

NPPES record last updated: December 10, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 10, 2021, Apr 28, 2021, Nov 3, 2020 (3 updates tracked since 2020).

About Jacalyn R Tidwell NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACALYN R TIDWELL (NPI 1093316457) is an individual peer specialist in Tulsa, Oklahoma and active in the NPI registry since November 2020.

NPPES Registry Identity

NPI1093316457
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameJACALYN R TIDWELL
Location Address5310 E 31ST ST STE 600Tulsa, OK 74135-5018
Mailing Address5310 E 31st St Ste 600Tulsa, OK 74135-5018 · (918) 587-9471
Phone(918) 587-9471
Sole ProprietorNo
Enumeration DateNovember 3, 2020
Last NPPES UpdateDecember 10, 20213 updates tracked since enumeration
NPPES CertifiedDecember 10, 2021
✔ NPI 1093316457 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
5310 E 31ST ST STE 600, Tulsa, OK 74135
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Other Names 1

Other Name (5)Jacalyn R Ketcherside

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAMARIS PENA
Case Manager/Care Coordinator
5310 E 31ST ST STE 600
TULSA, OK 74135
Tulsa County (918) 600-3612
DIANE HANCHETT
Case Manager/Care Coordinator
5310 E 31ST ST STE 600
TULSA, OK 74135
Tulsa County (918) 600-3606
TRENTON RYAN PRSS
Peer Specialist
5310 E 31ST ST STE 600
TULSA, OK 74135
Tulsa County (918) 587-9471
MAGHEN A DRESSLAER LMSW
Social Worker (Clinical)
5310 E 31ST ST STE 600
TULSA, OK 74135
Tulsa County (918) 587-9471
MS. ABBY LYNN HELMAN WALENCIAK LPC, LADC
Counselor (Mental Health)
5310 E 31ST ST STE 600
TULSA, OK 74135
Tulsa County (918) 600-3671
YOLANDA GOODMAN
Case Manager/Care Coordinator
5310 E 31ST ST STE 600
TULSA, OK 74135
Tulsa County (918) 600-3606
MR. JOHN ROBERT GAVINO LCSW, MSW
Social Worker (Clinical)
5310 E 31ST ST STE 600
TULSA, OK 74135
Tulsa County (918) 600-3100
SIERRA BOWEN
Case Manager/Care Coordinator
5310 E 31ST ST STE 600
TULSA, OK 74135
Tulsa County (918) 600-3606

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacalyn Tidwell's NPI number?

The NPI number for Jacalyn Tidwell is 1093316457. It was assigned to this individual provider in the NPPES registry on November 3, 2020. The provider is also known as Jacalyn R Ketcherside.

Where is Jacalyn Tidwell located?

Jacalyn Tidwell practices at 5310 E 31st St Ste 600, Tulsa, OK 74135. The listed phone number is (918) 587-9471.

What is Jacalyn Tidwell's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Jacalyn Tidwell was last updated on December 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.