COMMUNITY IMPACT YOUTH & FAMILY SERVICES (NPI# 1124311485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124311485 |
| Entity Type | Organization |
| Organization Name | COMMUNITY IMPACT YOUTH & FAMILY SERVICES |
| Practice Address |
4209 Nw 23rd St. Suite 100 Oklahoma City OK 73107 |
| Mailing Address |
Po Box 95751 Oklahoma City OK 73143-5751 |
| Practice Telephone | 4058635724 |
| Mailing Telephone | 4058635724 |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2011-05-19 |
| Authorized Official Name | MS. LARRENDA DEANEISHA PATTERSON (THERAPIST) |
| Authorized Official Telephone | 4058635724 |
| Authorized Official Credential | MS, LADCU/S |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | Agencies | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
4209 NW 23RD ST. SUITE 100 |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144747999 | Ellen Rose Pochyly | Counselor | 2617 General Pershing Boulevard, Oklahoma City, OK 73107 | 2017-08-23 |
| 1609399906 | Carrie Ann Moore | Counselor | 2617 General Pershing Blvd., Oklahoma City, OK 73107 | 2017-07-19 |
| 1821511320 | Diana Lynn Spencer | Counselor | 2617generalpershingblvd, Oklahoma City, OK 73107 | 2017-07-18 |
| 1861859514 | Catherine Evans | Counselor | 500 N Meridian Ave Ste 409, Oklahoma City, OK 73107 | 2016-01-26 |
| 1871964551 | Kizzy Frazier | Student in an Organized Health Care Education/Training Program | 1233 N Warren Pl, Oklahoma City, OK 73107 | 2015-10-07 |
| 1538550629 | Oklahoma Department of Mental Health and Substance Abuse | Case Management | 2625 General Pershing Boulevard, Oklahoma City, OK 73107 | 2015-02-10 |
| 1952702276 | Andale Healthcare, LLC | Clinic/Center | 2305 N. Meridian, Oklahoma City, OK 73107 | 2014-09-05 |
| 1114339348 | John Walls | Psychologist | 2012 North Villa Avenue, Oklahoma City, OK 73107 | 2014-05-22 |
| 1376970517 | Latrice Warrior | Community/Behavioral Health | 2625 General Pershing Drive, Oklahoma City, OK 73107 | 2013-10-02 |
| 1326485541 | Debra Sue Vaughan | Counselor | 2617 Genral Pershing Blvd, Oklahoma City, OK 73107 | 2013-05-29 |
| Find all providers in zip 73107 | ||||
| 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 |
|---|---|---|---|---|
| 1669073623 | Keonte Criswell | Community/Behavioral Health | 11530 Andover Ct, Oklahoma City, OK 73130-8217 | 2020-11-05 |
| 1730798117 | Healing Minds Counseling LLC | Community/Behavioral Health | 5300 N Meridian Ave Ste 11, Oklahoma City, OK 73112-2179 | 2020-07-30 |
| 1679122287 | New Therapeutic Environment LLC | Community/Behavioral Health | 4301 Nw 63rd St Ste 307, Oklahoma City, OK 73116-1504 | 2019-09-06 |
| 1447808944 | Noahs Ark Aba and Autism Services | Community/Behavioral Health | 14413 S Robinson Ave, Oklahoma City, OK 73170-7233 | 2019-08-28 |
| 1477011195 | Perceptive Counseling Pllc | Community/Behavioral Health | Perceptive Counseling Pllc, 6900 N Classen Blvd, Oklahoma City, OK 73116-7210 | 2019-03-12 |
| 1225594542 | Life Solutions Counseling Agency LLC | Community/Behavioral Health | 6003 N Robinson Ave Ste 102, Oklahoma City, OK 73118-7425 | 2019-02-11 |
| 1083182299 | North Oklahoma County Mental Health Center | Community/Behavioral Health | 4021 S Walker Ave, Oklahoma City, OK 73109-6972 | 2018-11-06 |
| 1649754946 | Kidventures, LLC | Community/Behavioral Health | 1601 Sw 89th St Ste B100, Oklahoma City, OK 73159-6357 | 2018-09-21 |
| 1245710136 | Nexus Solutions for Autism of Oklahoma LLC | Community/Behavioral Health | 405 Nw 30th St, Oklahoma City, OK 73118-8606 | 2018-08-20 |
| 1255854725 | Mission Treatment Centers, Inc. | Community/Behavioral Health | 948 W Hefner Rd, Oklahoma City, OK 73114-6927 | 2017-07-17 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73107 |
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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.