MILLENNIUM MEDICAL SERVICES, L.L.C. (NPI# 1568897585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568897585 |
| Entity Type | Organization |
| Organization Name | MILLENNIUM MEDICAL SERVICES, L.L.C. |
| Other Organization Name | POTEAU CLINIC |
| Practice Address |
1212 Reynolds Ave Poteau OK 74953-4724 |
| Mailing Address |
3816 Shadowridge Dr Norman OK 73072-5308 |
| Practice Telephone | 8885737792 |
| Practice Fax Number | 8887538162 |
| Mailing Telephone | 8885737792 |
| Mailing Fax Number | 8887538162 |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2020-04-22 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200004820D | 05 |
| Other Name | Type Code |
|---|---|
| Poteau Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1528614146 | Millennium Medical Services, L.L.C. | Counselor | 245 W Wilshire Blvd Ste A, Oklahoma City, OK 73116-7754 | 2019-08-11 |
| 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 |
1212 REYNOLDS AVE |
| City | POTEAU |
| State | OK |
| Zip Code | 74953-4724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811518301 | Bonnie Dyer | Registered Nurse | 1212 Reynolds Ave, Poteau, OK 74953-4724 | 2020-05-06 |
| 1376163196 | Kelsey White | Case Manager/Care Coordinator | 1212 Reynolds Ave, Poteau, OK 74953-4724 | 2020-04-22 |
| 1063052538 | Ross Barnhart | Case Manager/Care Coordinator | 1212 Reynolds Ave, Poteau, OK 74953-4724 | 2020-01-13 |
| 1215575451 | Jacqueline Kay Lindenau | Case Manager/Care Coordinator | 1212 Reynolds Ave, Poteau, OK 74953-4724 | 2019-12-18 |
| 1457996423 | Amber Dishmon | Counselor | 1212 Reynolds Ave, Poteau, OK 74953-4724 | 2019-11-13 |
| 1124662416 | Kaila Willet | Case Manager/Care Coordinator | 1212 Reynolds Ave, Poteau, OK 74953-4724 | 2019-10-30 |
| 1780227454 | Caleb Christopher Blevins | Peer Specialist | 1212 Reynolds Ave, Poteau, OK 74953-4724 | 2019-10-24 |
| 1609419845 | Justin Mclaughlin | Case Manager/Care Coordinator | 1212 Reynolds Ave, Poteau, OK 74953-4724 | 2019-10-21 |
| 1699317008 | Natasha Lewis | Case Manager/Care Coordinator | 1212 Reynolds Ave, Poteau, OK 74953-4724 | 2019-10-17 |
| 1114568920 | Teran Barnhart | Case Manager/Care Coordinator | 1212 Reynolds Ave, Poteau, OK 74953-4724 | 2019-10-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235644550 | Kim Lynn Mcconnell | Case Manager/Care Coordinator | 907 Grace St., Poteau, OK 74953 | 2017-12-08 |
| 1356889745 | Brenda Stacy | Prevention Professional | 507 Drwey, Potesu, OK 74953 | 2017-02-06 |
| 1639621451 | Sabrina Danielle Minor | Case Manager/Care Coordinator | 15715 Greentop Road, Poteau, OK 74953 | 2016-10-27 |
| 1902352545 | Daniel Jesse Bruesch | Counselor | 600 Oklahoma Ave., Poteau, OK 74953 | 2016-09-01 |
| 1578912465 | Jo Ann Walden | Counselor | 507 Dewey Avenue, Poteau, OK 74953 | 2016-06-10 |
| 1154708477 | Kendal Repass | Specialist/Technologist | 17100 Nail Creek, Poteau, OK 74953 | 2015-05-06 |
| 1669891768 | Jennifer Branscum | Case Manager/Care Coordinator | 22681 Valley View Rd, Poteau, OK 74953 | 2014-04-16 |
| 1437582145 | Kim Loggains | Counselor | 2104 A-n. Broadway, Poteau, OK 74953 | 2013-08-16 |
| 1457783573 | Derek Morris | Counselor | 3111b N. Broadway St., Box 34, Poteau, OK 74953 | 2013-07-31 |
| 1568743177 | Carol Ann Oliver | Counselor | 34183 Country Club Lane, Poteau, OK 74953 | 2011-09-09 |
| Find all providers in zip 74953 | ||||
| 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 |
|---|---|---|---|---|
| 1801998240 | Kenneth W Foster | Psychiatry & Neurology | 604 Dewey Avenue, Poteau, OK 74953 | 2006-09-05 |
| 1982020657 | Physicians Billing Unlimited | Psychiatry & Neurology | 501 Dewey Ave, Poteau, OK 74953-4215 | 2014-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164062253 | Tabor Behavioral Health LLC | Psychiatry & Neurology | 2615 Ridgeway St, Ardmore, OK 73401-2901 | 2020-01-07 |
| 1134783863 | Sarah Thi Tran | Psychiatry & Neurology | 4444 E 41st St Ste B, Tulsa, OK 74135-2527 | 2019-04-29 |
| 1356828305 | Dr. Peteryne D. Miller, M.d. LLC | Psychiatry & Neurology | 4870 S Lewis Ave Ste 205, Tulsa, OK 74105-5153 | 2018-07-23 |
| 1457852659 | Mindful Psychiatry, PC | Psychiatry & Neurology | 5014 E 101st St Ste 200, Tulsa, OK 74137-5803 | 2018-02-22 |
| 1700385481 | Reeder Psychiatry Pllc | Psychiatry & Neurology | 2515 Nw 16th St, Oklahoma City, OK 73107-4839 | 2018-02-07 |
| 1245752617 | Irfan Ahmed | Psychiatry & Neurology | 900 E. Main St., Norman, OK 73070 | 2017-07-07 |
| 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 |
| 1053762807 | Daniel Pappas | Psychiatry & Neurology | 15225 Fairview Farm Rd., Edmond, OK 73013 | 2016-06-23 |
| 1679937197 | Geetika M Verma Md Plcc | Psychiatry & Neurology | 5100 N Brookline Ave Bldg Suite360, Oklahoma City, OK 73112-3623 | 2016-04-11 |
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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.