MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA (NPI# 1467617928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467617928 |
| Entity Type | Organization |
| Organization Name | MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA |
| Practice Address |
93 Broadlawn Village Ardmore OK 73401-1722 |
| Mailing Address |
Po Box 189 Ardmore OK 73402-0189 |
| Practice Telephone | 5802232537 |
| Practice Fax Number | 5802232487 |
| Mailing Telephone | 5802235070 |
| Mailing Fax Number | 5802235617 |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2008-07-24 |
| Authorized Official Name | ROBERT E. LEE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5802235070 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100728830 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235394792 | Mental Health Services of Southern Oklahoma | Case Management | 93 Broadlawn Village, Ardmore, OK 73401-1722 | 2008-07-24 |
| 1922266964 | Mental Health Services of Southern Oklahoma | Community/Behavioral Health | #2 Broadlawn, Ardmore, OK 73402-1722 | 2008-05-27 |
| 1144404252 | Mental Health Services of Southern Oklahoma | Clinic/Center | 91 Broadlawn, Ardmore, OK 73401 | 2007-12-26 |
| 1780867812 | Mental Health Services of Southern Oklahoma | Clinic/Center | 209 E Wilson St, Tishomingo, OK 73460-2200 | 2007-12-12 |
| 1760528970 | Mental Health Services of Southern Oklahoma | Case Management | 200 Wanda St, Marietta, OK 73448 | 2007-01-29 |
| 1710023924 | Mental Health Services of Southern Oklahoma | Clinic/Center | 93 Broadlawn, Ardmore, OK 73401-6337 | 2007-01-29 |
| 1992841100 | Mental Health Services of Southern Oklahoma | Case Management | 111 E 12th St, Ada, OK 74820-6501 | 2007-01-29 |
| 1972659910 | Mental Health Services of Southern Oklahoma | Clinic/Center | 603 S 1st St, Madill, OK 73446-3807 | 2007-01-25 |
| 1831245885 | Mental Health Services of Southern Oklahoma | Clinic/Center | 414 W Muskogee Ave, Sulphur, OK 73086-4614 | 2007-01-25 |
| 1518997097 | Mental Health Services of Southern Oklahoma | Community/Behavioral Health | 2530 S. Commerce, Building A, Ardmore, OK 73401-5519 | 2006-07-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA | 1012 14th Ave Nw, Ardmore, OK 73401-5734 |
| Oklahoma Business Registrations | MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA | Po Box 189, Ardmore, OK 73402 |
| Oklahoma Business Registrations | MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA, INC. |
| Street Address |
93 BROADLAWN VILLAGE |
| City | ARDMORE |
| State | OK |
| Zip Code | 73401-1722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235394792 | Mental Health Services of Southern Oklahoma | Case Management | 93 Broadlawn Village, Ardmore, OK 73401-1722 | 2008-07-24 |
| 1427213982 | Mental Health Services of Southern Oklahoma | Clinic/Center | 93 Broadlawn Village, Ardmore, OK 73401-1722 | 2008-07-24 |
| 1265697726 | Mental Health Services of Southern Oklahoma | Case Management | 93 Broadlawn Village, Ardmore, OK 73401-1722 | 2008-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497391452 | Abbie Deeann Mclemore | Nurse Practitioner | 915 10th Ave, Ardmore, OK 73401 | 2019-11-25 |
| 1790349991 | Shirley Denise Brown | Licensed Psychiatric Technician | 1219 Kst N.w, 1219 Kst N.w, Ardmore, OK 73401 | 2019-04-24 |
| 1427512359 | Billy Joe Oshields | Case Manager/Care Coordinator | 6862 State Hwy 199 Ardmore Oklahoma, 6862 State Hwy 199, Ardmore, OK 73401 | 2019-01-24 |
| 1174007595 | Tawnya Dawn Peery | Nurse Practitioner | 1108 W. Walnut Drive, Ardmore, OK 73401 | 2018-09-21 |
| 1679055016 | Teresa Marie Hernandez | Behavior Technician | 1219 K St. Nw, Ardmore, OK 73401 | 2018-09-01 |
| 1063991974 | Sawyer Rae Shamburger | Occupational Therapy Assistant | 208 North Praire St, Pilot Point, TX 73401 | 2018-08-10 |
| 1417473521 | Chelsye Bacon | Peer Specialist | 905 Holiday Drive, Ardmore, OK 73401 | 2017-08-21 |
| 1003279746 | Jeni Presley | Marriage & Family Therapist | Outpatient Services-ardmore; 2510 Chickasaw Dr., Strong Family Development;, Ardmore, OK 73401 | 2016-03-31 |
| 1982080909 | Alison Hill | Pharmacist | 1111 N. Commerce, Ardmore, OK 73401 | 2015-07-31 |
| 1316346547 | Olivia Larae Carrell | Counselor | 15 Monroe Street Ne, Ardmore, OK 73401 | 2014-08-13 |
| Find all providers in zip 73401 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508499401 | Julia Jones, Lpc, Pllc | Clinic/Center | 2000 E 15th St Ste 400, Edmond, OK 73013-6697 | 2020-02-19 |
| 1285273920 | Psychiatric Wellness Aprn-cnp Pllc | Clinic/Center | 600 W Boeing Dr Ste D, Midwest City, OK 73110-3035 | 2019-12-28 |
| 1750942074 | Current Intervention Family Therapy Services | Clinic/Center | 2223 N Main St, Miami, OK 74354-1620 | 2019-06-26 |
| 1609431790 | New View Therapy | Clinic/Center | 3113 24th Ave Se, Norman, OK 73071-1742 | 2019-05-05 |
| 1932665841 | Flow Counseling Services | Clinic/Center | 6130 E 32nd St Ste 104, Tulsa, OK 74135-5454 | 2019-02-15 |
| 1427551860 | Bold Hearts and Sound Minds LLC | Clinic/Center | 1601 S State St Ste 375, Edmond, OK 73013-3626 | 2018-03-12 |
| 1427557891 | G Parks Phd Pllc | Clinic/Center | 6608 N Western Ave # 453, Oklahoma City, OK 73116-7326 | 2018-02-12 |
| 1578061578 | Life Mind, Pllc | Clinic/Center | 2624 E 22nd Pl, Tulsa, OK 74114-3131 | 2018-01-25 |
| 1144739657 | Healing Hearts Counseling & Consulting, L.L.C. | Clinic/Center | 1212 East Kirk, Hugo, OK 74743 | 2017-09-27 |
| 1851800825 | Seyva LLC | Clinic/Center | 8522 S 70th E Ave, Tulsa, OK 74133 | 2017-09-21 |
| 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.