SOUTHERN OKLAHOMA TREATMENT SERVICES (NPI# 1033456355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033456355 |
| Entity Type | Organization |
| Organization Name | SOUTHERN OKLAHOMA TREATMENT SERVICES |
| Practice Address |
1307 Sw Washington Ave Lawton OK 73501-7231 |
| Mailing Address |
Po Box 48 Mead OK 73449-0048 |
| Practice Telephone | 4052089354 |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2013-01-07 |
| Authorized Official Name | SHANDY SHUBIN (ADMINISTRATION) |
| Authorized Official Telephone | 4052089354 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790089829 | Southern Oklahoma Treatment Services | Community Based Residential Treatment Facility, Mental Illness | 5862 Us Hwy 70, Mead, OK 73449 | 2011-01-04 |
| Street Address |
1307 SW WASHINGTON AVE |
| City | LAWTON |
| State | OK |
| Zip Code | 73501-7231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619457819 | Candy Renee Tryggestad | Social Worker | 1307 Sw Washington Ave, Lawton, OK 73501-7231 | 2018-08-16 |
| 1336627686 | Ron'e Casella | Peer Specialist | 1307 Sw Washington Ave, Lawton, OK 73501-7231 | 2018-07-30 |
| 1245770858 | Carla Jean Troup | Counselor | 1307 Sw Washington Ave, Lawton, OK 73501-7231 | 2017-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596729 | Alyssa K Manfredi | Speech-Language Pathologist | 1700 Nw Lee Blvd, Lawton, OK 73501 | 2020-10-21 |
| 1295079705 | Premier Behavorial Health | Community/Behavioral Health | 2305 Southwest H Avenue, Suite #1, Lawton, OK 73501 | 2012-11-21 |
| 1306156989 | Diana Nix | Licensed Practical Nurse | 611 Sw B Ave, Lawton, OK 73501 | 2010-10-15 |
| 1689993214 | Crystal Leday | Physical Therapy Assistant | 602 S.e. Wallock, Lawton, OK 73501 | 2010-05-21 |
| 1457679862 | Gary Dean Gardner | Dentist | 1301 West Gore Blvd, Suite 2, Lawton, OK 73501 | 2010-05-10 |
| 1962729848 | Tayler Gammon | Hearing Instrument Specialist | 423 S.w. C Ave, Lawton, OK 73501 | 2010-04-30 |
| 1932430725 | Eric B Carpenter Sr. | Counselor | 807 Sw F Avenue, Lawton, OK 73501 | 2010-01-19 |
| 1447487640 | Benjamin Llanos | Counselor | 1719 Sw 11th, Lawton, OK 73501 | 2009-06-15 |
| 1710122833 | Provide Hearing Aids | Public Health or Welfare | 1201 West Gore Blvd, Suite D, Lawton, OK 73501 | 2008-12-03 |
| 1053506121 | Mercer Beauty Supply | Orthotic Fitter | 1016 Sw D Ave, Lawton, OK 73501 | 2007-09-11 |
| Find all providers in zip 73501 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811557200 | Inertia Services LLC | Counselor | 1311 Sw Washington Ave, Lawton, OK 73501-7231 | 2019-06-18 |
| 1992179923 | Sonya Ann Smalley | Counselor | 214 Nw 44th St Apt 214f, Lawton, OK 73505-6047 | 2015-11-13 |
| 1598107179 | Cynthia Blackwell | Counselor | 702 Nw Homestead Dr, Lawton, OK 73505-5205 | 2013-07-23 |
| 1356619431 | Jaynee Marie Nelson | Counselor | 2305 Sw H Ave, 1, Lawton, OK 73505-8103 | 2011-12-05 |
| 1720307135 | Muhammad Ali | Counselor | 5326 Nw Elm Ave, Lawton, OK 73505-4622 | 2010-05-25 |
| 1063734952 | Marion Stelly | Counselor | 5 Nw 27th St, Lawton, OK 73505-6209 | 2010-02-19 |
| 1932430725 | Eric B Carpenter Sr. | Counselor | 807 Sw F Avenue, Lawton, OK 73501 | 2010-01-19 |
| 1184950693 | Krystal Meredith Lewis | Counselor | 605 W Gore Blvd Ste 1, Lawton, OK 73501-3732 | 2009-10-19 |
| 1447487640 | Benjamin Llanos | Counselor | 1719 Sw 11th, Lawton, OK 73501 | 2009-06-15 |
| 1154506137 | Glenda Faye Haynes | Counselor | 411 W Gore Blvd, Lawton, OK 73501-3710 | 2008-01-08 |
| Find all providers in LAWTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.