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NORTHEASTERN HEALTH SYSTEM
NPI 1689338519
Counselor - Addiction (Substance Use Disorder) in Tahlequah, OK

Active since October 27, 2021CLIA 37D2260969 · Waiver
1323 W KEETOOWAH ST, TAHLEQUAH, OK 74464(918) 506-6901 Get Directions Write a Review

NPPES record last updated: November 7, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Northeastern Health System NPPES

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

NORTHEASTERN HEALTH SYSTEM (NPI 1689338519) is a healthcare organization registered as an addiction (substance use disorder) in Tahlequah, Oklahoma and active in the NPI registry since October 2021. The organization holds a CLIA Waiver certificate valid through May 24, 2028, maintains a secondary practice location in Wagoner, and lists Jackie Hullinger, Vp Of Revenue Cycle, as its authorized official.

NPPES Registry Identity

NPI1689338519
Entity TypeOrganization
Primary Taxonomy101YA0400X
Legal Business NameNORTHEASTERN HEALTH SYSTEM
Location Address1323 W KEETOOWAH STTahlequah, OK 74464-3462
Mailing AddressPo Box 1008Tahlequah, OK 74465-1008 · (918) 458-2111
Phone(918) 506-6901
Organization SubpartNo
Authorized OfficialJackie HullingerVp Of Revenue Cycle · (918) 458-2417
Enumeration DateOctober 27, 2021
Last NPPES UpdateNovember 7, 2024
NPPES CertifiedNovember 7, 2024
✔ NPI 1689338519 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
1323 W KEETOOWAH ST, Tahlequah, OK 74464
Open in Google Maps ↗

Secondary Practice Location 1

Location 1215 NE 1st St Ste BWagoner, OK 74467-4439 · Phone (918) 931-3890

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D2260969

Northeastern Health System Addiction Resource Ctr · Tahlequah, OK
Active · expires May 24, 2028
CLIA Number37D2260969
Laboratory TypeAddiction Treatment Ctr
Certificate Effective DateMay 25, 2026
Certificate Expiration DateMay 24, 2028
Laboratory DirectorJason Ballew
Laboratory Phone(918) 931-3890
Laboratory LocationNortheastern Health System Addiction Resource Ctr1323 W Keetoowah St, Tahlequah, OK 74464
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

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

JENNIE SHAE WASHINGTON
Peer Specialist
1323 W KEETOOWAH ST
TAHLEQUAH, OK 74464
Cherokee County (918) 506-6901
RACHEL FREIHOFF-LEWIN LPN
Case Manager/Care Coordinator
1323 W KEETOOWAH ST
TAHLEQUAH, OK 74464
Cherokee County (918) 931-3890
DUSTY ROLLICE PRSS
Peer Specialist
1323 W KEETOOWAH ST
TAHLEQUAH, OK 74464
Cherokee County (918) 316-0573
LOFTIN FAMILY PRACTICE
Clinic/Center
1323 W KEETOOWAH ST
TAHLEQUAH, OK 74464
Cherokee County (918) 456-3425
RACHEL ELIZABETH CLINTON
Case Manager/Care Coordinator
1323 W KEETOOWAH ST
TAHLEQUAH, OK 74464
Cherokee County (918) 708-3006
STEPHANIE JOLENE WHIPPLE
Case Manager/Care Coordinator
1323 W KEETOOWAH ST
TAHLEQUAH, OK 74464
Cherokee County (918) 708-3006
GRAND LAKE MENTAL HEALTH CENTER, INC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
1323 W KEETOOWAH ST
TAHLEQUAH, OK 74464
Cherokee County (918) 708-3006
HOLLY CADDELL
Counselor (Mental Health)
1323 W KEETOOWAH ST
TAHLEQUAH, OK 74464
Cherokee County (918) 708-3006

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 Northeastern Health System's NPI number?

The NPI number for Northeastern Health System is 1689338519. It was assigned to this organization in the NPPES registry on October 27, 2021.

Where is Northeastern Health System located?

Northeastern Health System is located at 1323 W Keetoowah St, Tahlequah, OK 74464. The listed phone number is (918) 506-6901.

What is Northeastern Health System's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Does Northeastern Health System hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D2260969) is associated with this NPI, valid through May 24, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Northeastern Health System accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Northeastern Health System as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Northeastern Health System was last updated on November 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.