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ETHAN SHANE KIDD
NPI 1972357739
Peer Specialist in Tulsa, OK

Active since April 16, 2024
6128 E 38TH ST, TULSA, OK 74135(918) 779-7144(918) 663-0203 Get Directions Write a Review

NPPES record last updated: April 16, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ethan Shane Kidd NPPES

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

ETHAN SHANE KIDD (NPI 1972357739) is an individual peer specialist in Tulsa, Oklahoma and active in the NPI registry since April 2024.

NPPES Registry Identity

NPI1972357739
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameETHAN SHANE KIDD
Location Address6128 E 38TH STTulsa, OK 74135-5832
Mailing Address6128 E 38th StTulsa, OK 74135-5832 · (918) 779-7144 · Fax (918) 663-0203
Phone(918) 779-7144
Fax(918) 663-0203
Sole ProprietorNo
Enumeration DateApril 16, 2024
NPPES CertifiedApril 16, 2024
✔ NPI 1972357739 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.
6128 E 38TH ST, Tulsa, OK 74135
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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.

MADISON COLCLAZIER RN
Registered Nurse (Infusion Therapy)
6128 E 38TH ST
TULSA, OK 74135
Tulsa County (539) 240-7461
KIMBERLY TRIPP
Peer Specialist
6128 E 38TH ST
TULSA, OK 74135
Tulsa County (918) 664-4224
RILEY JOANN CHRISTIAN
Peer Specialist
6128 E 38TH ST
TULSA, OK 74135
Tulsa County (918) 779-7115
DESTINY HOPE DAVIS
Case Manager/Care Coordinator
6128 E 38TH ST
TULSA, OK 74135
Tulsa County (580) 304-2674
NATHALIE PAREDES RODRIGUEZ
Licensed Practical Nurse
6128 E 38TH ST
TULSA, OK 74135
Tulsa County (918) 884-5217
KAYLA NICOLE RIDLEY
Case Manager/Care Coordinator
6128 E 38TH ST
TULSA, OK 74135
Tulsa County (844) 458-2100
GREG ALAN CLAUSON
Peer Specialist
6128 E 38TH ST
TULSA, OK 74135
Tulsa County (539) 242-3322
LAURA LEIGH STRAIN LCSW (UNDER SUP)
Counselor (Mental Health)
6128 E 38TH ST
TULSA, OK 74135
Tulsa County (539) 369-7042

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 Ethan Kidd's NPI number?

The NPI number for Ethan Kidd is 1972357739. It was assigned to this individual provider in the NPPES registry on April 16, 2024.

Where is Ethan Kidd located?

Ethan Kidd practices at 6128 E 38th St, Tulsa, OK 74135. The listed phone number is (918) 779-7144.

What is Ethan Kidd'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 Ethan Kidd was last updated on April 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.