MENTAL WELLNESS SERVICES, LLC (NPI# 1346660412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346660412 |
| Entity Type | Organization |
| Organization Name | MENTAL WELLNESS SERVICES, LLC |
| Practice Address |
3605 Nw 175th St Edmond OK 73012-6901 |
| Practice Telephone | 4054701884 |
| Practice Fax Number | 4054701028 |
| Mailing Telephone | 4054701884 |
| Mailing Fax Number | 4054701028 |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2014-04-16 |
| Authorized Official Name | DENISE CATO (ADMINISTRATOR) |
| Authorized Official Telephone | 4054701884 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TH0100X |
Psychologist Specialization: Health Service |
Behavioral Health & Social Service Providers |
| Street Address |
3605 NW 175TH ST |
| City | EDMOND |
| State | OK |
| Zip Code | 73012-6901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962013912 | Ashley Lambert | Counselor | 19501 N Pennsylvia, Apt 210, Edmond, OK 73012 | 2020-08-13 |
| 1699316083 | First Rate Eye Care Pllc | Optometrist | 1140 Nw 192nd St., Suite A, Edmond, OK 73012 | 2019-10-07 |
| 1659869881 | Brent Byers | Registered Nurse | 3040 Nw 179th Ct, Edmond, OK 73012 | 2018-04-24 |
| 1386173672 | John A Hale | Respiratory Therapist, Certified | 19100 Meadows Crossing Drive, Edmond, OK 73012 | 2017-06-08 |
| 1740715598 | Ryan Hays | Counselor | 620 Nw 178 St., Apt. 4c, Edmond, OK 73012 | 2017-04-28 |
| 1245691336 | Jessica Collins | Behavioral Analyst | 18217 Sandhurst Ct, Edmond, OK 73012 | 2016-03-16 |
| 1538545801 | Cynthia Ann Thompson | Case Manager/Care Coordinator | 1732 Kelly, Edmond, OK 73012 | 2015-08-10 |
| 1538564224 | Function Physical Therapy, LLC | Physical Therapist | 16502 N Pennsylvania Ave, Suite C, Edmond, OK 73012 | 2014-10-24 |
| 1003227414 | Deer Creek Family Healthcare and Wellness Clinic LLC | Clinic/Center | 19401 N. Portland, Edmond, OK 73012 | 2014-05-20 |
| 1316383649 | Ralphs Family Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 1101 Nw178th Street, Suite A, Edmond, OK 73012 | 2013-05-14 |
| Find all providers in zip 73012 | ||||
| Taxonomy Code | 103TH0100X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Health Service |
| A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). |
| Notes: Source: National Register of Health Service Providers in Psychology website http://www.nationalregister.org/about_NR.html [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497837017 | Lee A Thrash | Psychologist | 407 W 15th St, Ste. 7, Edmond, OK 73013-3745 | 2006-10-20 |
| 1437340528 | James Riley Keller | Psychologist | 1800 Renaissance Blvd, Edmond, OK 73013-3023 | 2007-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457827016 | Grundy Psychological Services, P.C. | Psychologist | 205 Ketchum Avenue, Ketchum, OK 74349 | 2018-10-22 |
| 1891212551 | Mary Elizabeth Mohon | Psychologist | Oklahoma Vamc 921 Ne 13th Street, 11g, Oklahoma City, OK 73104 | 2017-08-24 |
| 1255855110 | Christopher Thomas Copeland | Psychologist | 920 Stanton L Young Blvd # Wp3445, Oklahoma City, OK 73104-5036 | 2017-08-01 |
| 1588063085 | La'queion Ballard | Psychologist | 2221 Ne 24th St, Oklahoma City, OK 73111-3421 | 2014-08-20 |
| 1285915710 | Gloria P Okelley | Psychologist | 4400 Hemingway Dr., # 221, Oklahoma City, OK 73118 | 2011-08-29 |
| 1023214392 | Robert J. Powitzky | Psychologist | 4710 Hemlock Cir, Oklahoma City, OK 73162-1938 | 2007-06-25 |
| 1407070790 | Ralph Edmond Lindsey | Psychologist | 115 E 4th Ave, Stillwater, OK 74074-3527 | 2007-04-11 |
| 1497877765 | Omar Wr Muhammad | Psychologist | 3312 E Maxwell Dr, Oklahoma City, OK 73121-2246 | 2007-04-05 |
| 1386787661 | Lisa Myers Black | Psychologist | 4003 24th Ave Ne, Norman, OK 73071-7749 | 2007-02-15 |
| 1043393234 | Curtis Todd Grundy | Psychologist | 1520 North Industrial Rd, Vinita, OK 74301 | 2006-10-23 |
| Find all providers with the same taxonomy | ||||
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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.