NORTHEASTERN HEALTH SYSTEM
NPI 1689338519
Counselor - Addiction (Substance Use Disorder) in Tahlequah, OK
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.Information from the official NPPES registry record, last updated November 7, 2024.
NPPES Registry Identity
★ Primary Specialty
Also on File with NPPES
Wagoner, OK 74467-4439
Phone (918) 931-3890
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 37D2260969
- Facility Type
- Other - ADDICTION TREATMENT CTR
- Certificate Effective Date
- May 25, 2026
- Certificate Expiration Date
- May 24, 2028
- Laboratory Director
- JASON BALLEW
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Northeastern Health System to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 10 providers are registered at the same or a nearby location.
TAHLEQUAH, OK 74464
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1689338519, enumerated as an "organization" on October 27, 2021.
The provider is located at 1323 W KEETOOWAH ST TAHLEQUAH, OK 74464 and the phone number is (918) 506-6901.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.
