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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

MRS. KENNEDY MANTRICE SCULLAWL
NPI 1093619652
Peer Specialist in Nowata, OK

Active since October 06, 2026
325 S ASH ST, NOWATA, OK 74048(844) 458-2100 Get Directions Write a Review

NPPES record added: October 6, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

About Mrs. Kennedy Mantrice Scullawl NPPES

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

MRS. KENNEDY MANTRICE SCULLAWL (NPI 1093619652) is an individual peer specialist in Nowata, Oklahoma and active in the NPI registry since October 2026.

NPPES Registry Identity

NPI1093619652
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameMRS. KENNEDY MANTRICE SCULLAWL
Location Address325 S ASH STNowata, OK 74048-4628
Mailing Address200 Wauhillau Ct Apt 103Nowata, OK 74048-2443 · (918) 580-3023
Phone(844) 458-2100
Sole ProprietorYes
Enumeration DateOctober 6, 2026
NPPES CertifiedOctober 6, 2026
✔ NPI 1093619652 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.
325 S ASH ST, Nowata, OK 74048
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Other Providers at the Same Location NPPES 20

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

GRAND LAKE MENTAL HEALTH CENTER, INC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
325 S ASH ST
NOWATA, OK 74048
Nowata County (918) 273-7344
SAMANTHA BAYLES LPCC
Counselor (Mental Health)
325 S ASH ST
NOWATA, OK 74048
Nowata County (844) 458-2100
STEPHANIE REDDING
Marriage & Family Therapist
325 S ASH ST
NOWATA, OK 74048
Nowata County (918) 273-7344
WENDY BOHORQUEZ
Counselor (Professional)
325 S ASH ST
NOWATA, OK 74048
Nowata County (918) 273-7344
PORCHIA LYNN SILAS RN
Registered Nurse
325 S ASH ST
NOWATA, OK 74048
Nowata County (918) 273-1841
JESSIE SUTTON
Case Manager/Care Coordinator
325 S ASH ST
NOWATA, OK 74048
Nowata County (844) 458-2100
BAILEY KERNS
Peer Specialist
325 S ASH ST
NOWATA, OK 74048
Nowata County (844) 458-2100
MR. SCOTT LLOYD DAVIS
Case Manager/Care Coordinator
325 S ASH ST
NOWATA, OK 74048
Nowata County (918) 273-7344

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 Kennedy Scullawl's NPI number?

The NPI number for Kennedy Scullawl is 1093619652. It was assigned to this individual provider in the NPPES registry on October 6, 2026.

Where is Kennedy Scullawl located?

Kennedy Scullawl practices at 325 S Ash St, Nowata, OK 74048. The listed phone number is (844) 458-2100.

What is Kennedy Scullawl'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 Kennedy Scullawl was last updated on October 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days 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.