Billy Jack
Counselor - Addiction (Substance Use Disorder) • Ada, OK
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Billy Jack has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Billy Jack was a registered Counselor - Addiction (Substance Use Disorder) practicing in Ada, OK. Throughout an active medical career spanning 14 years, Billy Jack provided care at the practice location at 1001 N COUNTRY CLUB RD until profile deactivation on 2020-07-17.
Practice Location & Contact Primary Location
1001 N Country Club Rd
Ada, OK 748202847
Specialty Benchmarks & Practice Insights
Comparative analytics for Counselor - Addiction (Substance Use Disorder) in Ada, OK
Practicing in Ada, OK (1474 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 101YA0400X
Definition to come...
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Dentist
Doctor of Dental Surgery
Obstetrics & Gynecology
Doctor of Medicine (M.D.)
Pharmacy Technician
Emergency Medicine
Doctor of Osteopathic Medicine (D.O.)
Physical Medicine & Rehabilitation
Pharmacist
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on July 17, 2020
NPI status registered as active in NPPES database
Registered at 1001 N COUNTRY CLUB RD, ADA, OK 748202847 (Tel: 5804214570)
Registered at 1001 N COUNTRY CLUB RD, ADA, OK 748202847 (Tel: 5804214570)
Recorded as BILLY JACK
Counselor (License #248 in OK)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
1001 N Country Club Rd
Ada, OK 748202847
Phone: 5804214570
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