Ethan Randall, in Tahlequah, OK - Medicare Provider

Ethan Randall, is a medicare enrolled "Social Worker - Clinical" provider in Tahlequah, Oklahoma. His current practice location is 217 N Water Ave, Tahlequah, Oklahoma. You can reach out to his office (for appointments etc.) via phone at (888) 692-6590.

Ethan Randall is licensed to practice in Oklahoma (license number 8189) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1508526773.

Contact Information

	Ethan Randall,
	217 N Water Ave, Tahlequah, OK 74464-2825
	(888) 692-6590
	Not Available

Healthcare Provider's Profile

Full Name	Ethan Randall
Gender	Male
Speciality
Experience	Years
Location	217 N Water Ave, Tahlequah, Oklahoma
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Ethan Randall attended and graduated from in

NPI Data:

NPI Number: 1508526773
Provider Enumeration Date: 12/29/2021
Last Update Date: 02/26/2024

Medicare PECOS Information:

PECOS PAC ID:
Enrollment ID:

Medical Identifiers

Medical identifiers for Ethan Randall such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1508526773	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	8189 (Oklahoma)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethan Randall is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ethan Randall, 217 N Water Ave, Tahlequah, OK 74464-2825 Ph: (888) 692-6590	Ethan Randall, 217 N Water Ave, Tahlequah, OK 74464-2825 Ph: (888) 692-6590

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Social Worker in Tahlequah, OK

Ms. Pamela Kay Rusco, L.C.S.W. Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 100 S Bliss Avenue, Cherokee Nation Behavioral Health, Tahlequah, OK 74464 Phone: 918-458-3170 Fax: 918-458-3610
Crystal Williams, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 711 S Muskogee Ave, Tahlequah, OK 74464 Phone: 918-207-0078
Micala Cooper, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1510 E Shawnee Cir, Tahlequah, OK 74464 Phone: 918-772-4004
Sara Kay Perry, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 16414 W 760 Rd, Tahlequah, OK 74464 Phone: 918-708-9009
Michelle Lynn Deason, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 223 S College Ave, Tahlequah, OK 74464 Phone: 918-507-0711 Fax: 918-207-1661
Dawn Ballew, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 315 N College Ave, Tahlequah, OK 74464 Phone: 918-453-1171

Ethan Randall, - Medicare Clinical Social Worker in Tahlequah, OK