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KELLIE ODENEAL
NPI 1720707532
Peer Specialist in Wagoner, OK

Active since August 24, 2022
907 NW 5TH ST, WAGONER, OK 74467(918) 777-1241 Get Directions Write a Review

NPPES record last updated: August 24, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kellie Odeneal NPPES

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

KELLIE ODENEAL (NPI 1720707532) is an individual peer specialist in Wagoner, Oklahoma and active in the NPI registry since August 2022.

NPPES Registry Identity

NPI1720707532
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameKELLIE ODENEAL
Location Address907 NW 5TH STWagoner, OK 74467-3103
Mailing Address907 Nw 5th StWagoner, OK 74467-3103 · (918) 777-1241
Phone(918) 777-1241
Sole ProprietorYes
Enumeration DateAugust 24, 2022
NPPES CertifiedAugust 24, 2022
✔ NPI 1720707532 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.
907 NW 5TH ST, Wagoner, OK 74467
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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 Kellie Odeneal's NPI number?

The NPI number for Kellie Odeneal is 1720707532. It was assigned to this individual provider in the NPPES registry on August 24, 2022.

Where is Kellie Odeneal located?

Kellie Odeneal practices at 907 NW 5th St, Wagoner, OK 74467. The listed phone number is (918) 777-1241.

What is Kellie Odeneal'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 Kellie Odeneal was last updated on August 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.