MILLENNIUM MEDICAL SERVICES, L.L.C. (NPI# 1528614146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528614146 |
| Entity Type | Organization |
| Organization Name | MILLENNIUM MEDICAL SERVICES, L.L.C. |
| Other Organization Name | OKLAHOMA CITY CLINIC |
| Practice Address |
245 W Wilshire Blvd Ste A Oklahoma City OK 73116-7754 |
| Mailing Address |
3816 Shadowridge Dr Norman OK 73072-5308 |
| Practice Telephone | 8885737792 |
| Practice Fax Number | 8887538162 |
| Mailing Telephone | 4056270276 |
| Mailing Fax Number | 8887538162 |
| Enumeration Date | 2019-08-11 |
| Last Update Date | 2020-04-23 |
| Authorized Official Name | DR. WADE L HAMIL (CEO) |
| Authorized Official Telephone | 4056270276 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | Y |
| Parent Organization Name | MILLENNIUM MEDICAL SERVICES, L.L.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Oklahoma City Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568897585 | Millennium Medical Services, L.L.C. | Counselor | 1212 Reynolds Ave, Poteau, OK 74953-4724 | 2013-09-10 |
| 1922352475 | Millennium Medical Services, L.L.C. | Counselor | 14367 Se Highway 63, Talihina, OK 74571-5948 | 2012-11-06 |
| 1245286285 | Millennium Medical Services, L.L.C. | Counselor | 448 36th Ave Nw Ste 101, Norman, OK 73072-4743 | 2006-05-25 |
| 1295355840 | Millennium Medical Services, L.L.C. | Counselor | 503 S Central Ave, Idabel, OK 74745-6061 | 2020-04-23 |
| 1295128981 | Millennium Medical Services, L.L.C. | Counselor | 312 N Van Buren St, Enid, OK 73703-4500 | 2015-03-05 |
| 1013348846 | Millennium Medical Services, L.L.C. | Counselor | 221 W 3rd St, Hobart, OK 73651-3603 | 2013-12-04 |
| Street Address |
245 W WILSHIRE BLVD STE A |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73116-7754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972829695 | Myron Dewayne Mayberry | Counselor | 245 W Wilshire Blvd Ste A, Oklahoma City, OK 73116-7754 | 2010-04-20 |
| 1750855359 | Lisa Deshay Stanfield | Case Manager/Care Coordinator | 245 W Wilshire Blvd Ste A, Oklahoma City, OK 73116-7754 | 2019-01-16 |
| 1376047241 | Jamie Lynn Coles | Case Manager/Care Coordinator | 245 W Wilshire Blvd Ste A, Oklahoma City, OK 73116-7754 | 2018-03-23 |
| 1285161679 | Millennium Community Services, LLC | Clinic/Center | 245 W Wilshire Blvd Ste A, Oklahoma City, OK 73116-7754 | 2017-05-16 |
| 1861879934 | Kimberly Faith Brown | Counselor | 245 W Wilshire Blvd Ste A, Oklahoma City, OK 73116-7754 | 2015-04-28 |
| 1083952766 | Michael Ray Dyer | Counselor | 245 W Wilshire Blvd Ste A, Oklahoma City, OK 73116-7754 | 2013-01-30 |
| 1386901445 | Emanuel Moses Grimes | Counselor | 245 W Wilshire Blvd Ste A, Oklahoma City, OK 73116-7754 | 2012-04-13 |
| 1376816652 | Tramaine Jamal Hilton | Counselor | 245 W Wilshire Blvd Ste A, Oklahoma City, OK 73116-7754 | 2012-02-16 |
| 1154692432 | Raechelle Renye Reed | Counselor | 245 W Wilshire Blvd Ste A, Oklahoma City, OK 73116-7754 | 2012-01-19 |
| 1306122320 | Latoya Rena Anderson | Counselor | 245 W Wilshire Blvd Ste A, Oklahoma City, OK 73116-7754 | 2011-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306455068 | Restore Family Counseling, LLC | Clinic/Center | 100 W. Wilshire, Suite #c3, Oklahoma City, OK 73116 | 2020-07-29 |
| 1861058877 | Dental Depot of 63rd & Nw Expressway, Pllc | Clinic/Center | 4025 Nw 63rd Street, Oklahoma City, OK 73116 | 2019-05-15 |
| 1073001756 | Oklahoma Clinical Management LLC | Prevention Professional | 4301 Nw 63rd St Ste 107, Oklahoma City, OK 73116 | 2018-04-27 |
| 1235658261 | Heinen Physical Therapy, PC | Clinic/Center | 7710 N May Ave, Oklahoma City, OK 73116 | 2017-09-11 |
| 1235657842 | Jacque S Komers | Counselor | 6501 N Broadway Ext Suite 180, Oklahoma City, OK 73116 | 2017-09-04 |
| 1164943874 | Jo Ann Cole-johnson | Counselor | 6505 N. Shawnee Ave, Oklahoma, OK 73116 | 2017-07-03 |
| 1548790793 | Zachary Wayne Skates | Case Manager/Care Coordinator | North 6501 Broadway Extention Highway #180, Oklahoma City, OK 73116 | 2017-06-19 |
| 1548622673 | Jessica Defiore | Case Manager/Care Coordinator | 6501 N Broadway Extension, Oklahoma City, OK 73116 | 2016-03-28 |
| 1093173247 | Patrice Ann Cook | Specialist/Technologist, Other | 7700 N. Hudson Ave, Suite Number 9, Oklahoma City, OK 73116 | 2016-02-03 |
| 1467880708 | Abrina Marie Kneeland | Occupational Therapy Assistant | 6525 N. Meridian #311, Therapists Unlimited Division of Career Staff, Oklahoma City, OK 73116 | 2013-10-24 |
| Find all providers in zip 73116 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700385481 | Reeder Psychiatry Pllc | Psychiatry & Neurology | 2515 Nw 16th St, Oklahoma City, OK 73107-4839 | 2018-02-07 |
| 1568997401 | Erin Walling | Psychiatry & Neurology | 920 Stanton L Young Blvd Ste 3440, Oklahoma City, OK 73104-5036 | 2017-04-28 |
| 1992259501 | Tranquil Psychiatry Clinic,llc | Psychiatry & Neurology | 333 Nw 5th St, Apt. No. 1010, Oklahoma City, OK 73102-3080 | 2016-08-11 |
| 1679937197 | Geetika M Verma Md Plcc | Psychiatry & Neurology | 5100 N Brookline Ave Bldg Suite360, Oklahoma City, OK 73112-3623 | 2016-04-11 |
| 1104232768 | Ayesha Sattar | Psychiatry & Neurology | 920 Stanton L Young Blvd # Wp3039, Oklahoma City, OK 73104-5036 | 2014-07-03 |
| 1457791444 | Thuy Hong Nguyen | Psychiatry & Neurology | 5100 N Brookline Ave Ste 900, Oklahoma City, OK 73112-3630 | 2013-07-05 |
| 1851684971 | Spring Child & Adult Psychiatry Pllc | Psychiatry & Neurology | 11032 Quail Creek Rd Ste 107, Oklahoma City, OK 73120-6208 | 2011-05-23 |
| 1093941452 | Courtney Nixon | Psychiatry & Neurology | 3135 Nw 63rd St, Suite A, Oklahoma City, OK 73116-3701 | 2009-05-29 |
| 1982856548 | Sebastian PC | Psychiatry & Neurology | 4100 W Memorial, Suite 221, Oklahoma City, OK 73120 | 2008-10-15 |
| 1932312691 | Andrea James | Psychiatry & Neurology | 1330 N Classen Blvd Ste 112, Oklahoma City, OK 73106-6834 | 2007-05-08 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73116 |
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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.