MENTAL HEALTH SERVICE OF SOUTHERN OKLAHOMA (NPI# 1093349003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093349003 |
| Entity Type | Organization |
| Organization Name | MENTAL HEALTH SERVICE OF SOUTHERN OKLAHOMA |
| Practice Address |
2425 W University Blvd Durant OK 74701-2942 |
| Mailing Address |
Po Box 189 Ardmore OK 73402-0189 |
| Practice Telephone | 5809247330 |
| Practice Fax Number | 5809242739 |
| Mailing Telephone | 5803197305 |
| Mailing Fax Number | 5803197328 |
| Enumeration Date | 2020-02-28 |
| Last Update Date | 2020-02-28 |
| Authorized Official Name | MAUNA LIA (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Telephone | 5803197305 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100728830 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801295464 | Mental Health Service of Southern Oklahoma | Voluntary or Charitable | 1001 W Main St, Durant, OK 74701-5038 | 2014-08-20 |
| Street Address |
2425 W UNIVERSITY BLVD |
| City | DURANT |
| State | OK |
| Zip Code | 74701-2942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518087899 | Charles W Bachmann IIi | Dentist | 2425 W University Blvd, Durant, OK 74701-2944 | 2007-03-30 |
| 1316546104 | Nathan Starry | Case Manager/Care Coordinator | 2425 W University Blvd, Durant, OK 74701-2942 | 2020-10-22 |
| 1013542190 | Lighthouse Behavioral Wellness Centers | Psychiatry & Neurology | 2425 W University Blvd, Durant, OK 74701-2970 | 2020-03-09 |
| 1649454273 | Kenneth L. Cone Dds, PC | Dentist | 2425 W University Blvd, Durant, OK 74701-2944 | 2007-12-18 |
| 1598949125 | Charles W. Bachmann IIi, Dds PC | Dentist | 2425 W University Blvd, Durant, OK 74701-2944 | 2007-12-18 |
| 1205956521 | Dental Associates of Durant, Pllc | Dentist | 2425 W University Blvd, Durant, OK 74701-2944 | 2007-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134738362 | Elevate Therapy, Pllc | Physical Therapist | 523 N Wshington Ave, Durant, OK 74701 | 2020-07-23 |
| 1093334906 | Duncan Kovash | Nurse Practitioner | 1901 Chukka Hina, Durant, OK 74701 | 2020-04-10 |
| 1184193690 | Inventive Therapy Services, LLC | Occupational Therapist | 2620 Maxey Dr, Durant, OK 74701 | 2018-11-14 |
| 1790271831 | Jazmine Gabrielle Benavidez | Specialist/Technologist | 1713 North 1st Avenue, Durant, OK 74701 | 2018-07-02 |
| 1538659586 | Katelen Sue Morgan | Case Manager/Care Coordinator | 1011 Donna Sue Pl, Durant, OK 74701 | 2018-05-15 |
| 1164941035 | Nsight for Life LLC | Community/Behavioral Health | 1313 N 16th, Durant, OK 74701 | 2017-09-12 |
| 1023534666 | Damon Dye | Physical Therapist | 30 W 3rd St, Durant, OK 74701 | 2017-08-15 |
| 1437605250 | Casey Worsham | Nurse Practitioner | 1800 W University, Durant, OK 74701 | 2016-08-31 |
| 1083160857 | Denise Adanho | Case Manager/Care Coordinator | 1218 Stonebrook Circle, Durant, OK 74701 | 2016-08-31 |
| 1962850271 | Justi Thompson | Case Manager/Care Coordinator | 4817 Ciara St, Durant, OK 74701 | 2016-05-26 |
| Find all providers in zip 74701 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114565512 | Southern Oklahoma Treatment Services, Inc. | Community/Behavioral Health | 324 N Washington Ave, Durant, OK 74701-3642 | 2019-12-16 |
| 1164941035 | Nsight for Life LLC | Community/Behavioral Health | 1313 N 16th, Durant, OK 74701 | 2017-09-12 |
| 1093131328 | Southeastern Oklahoma Family Services, Inc. | Community/Behavioral Health | 127 North 3rd Avenue, Durant, OK 74701-0000 | 2014-03-11 |
| 1588951735 | Hartsell Psychological Services, Inc. | Community/Behavioral Health | 1604 N Washington, Durant, OK 74701 | 2011-07-07 |
| 1831409440 | Center for Psychological Development, Inc. | Community/Behavioral Health | 142 West Main Street, Durant, OK 74701 | 2010-10-15 |
| 1598959736 | Premier Family Life & Treatment Center, LLC | Community/Behavioral Health | 1314 W Evergreen St, Durant, OK 74701-4726 | 2007-08-30 |
| 1568587095 | Kiamichi Council On Alcoholism and Or Other Drug Abuse, Inc. | Community/Behavioral Health | 307 W Elm St, Suite 1, Durant, OK 74701-4109 | 2007-03-21 |
| 1982766739 | Hands of Hope, Inc. | Community/Behavioral Health | 4310 W University Blvd, Durant, OK 74701-4577 | 2006-12-15 |
| 1013092626 | Lifespan Counseling Professionals | Community/Behavioral Health | 212 W Evergreen St, Durant, OK 74701-4710 | 2006-10-25 |
| 1194114801 | Inspire Counseling & Psychological Services, LLC | Community/Behavioral Health | 114 S 7th Ave, Durant, OK 74701-5017 | 2015-01-19 |
| Find all providers in DURANT | ||||
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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.