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Christopher R Oxendale

Counselor

Behavioral Health & Social Service Providers

2004 Valparaiso St, Valparaiso, IN 46383-3138

PECOS Enrollment

This provider is enrolled in PECOS as CHRISTOPHER OXENDALE.

Based on the most recent information from CMS, provider Christopher R Oxendale is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 11:05 AM.

Profile Details

Provider ID
1588647994
Provider Type
Individual
Full Name
Oxendale, Christopher R
Credential
LMHC

Gender
Male
Sole Proprietor
No
Enumeration Date
11/21/2005
Last Updated
10/24/2024

Contact Information

Practice Location

2004 Valparaiso St, Valparaiso, IN 46383-3138

(219) 477-5646

(219) 728-4765

Mailing Location

2004 Valparaiso St, Valparaiso, IN 46383-3138

(219) 477-5646

(219) 728-4765

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License 39000030A Indiana

Provider Identifiers

ID	Description	Issuer
ID 300058598	Description Medicaid	Issuer Unlisted Indiana

Christopher R Oxendale

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Tuohy, Amanda L

Baker, Robert James

Williams, Gina

Mullenhour, Jamie Lynn

Olson-Burkhardt, Diane K

Williams, Vera

Hughes, Dean E

Cornett, Amanda C

Driver, Steven David

Wurster, Sarah Marie