MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA (NPI# 1710023924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710023924 |
| Entity Type | Organization |
| Organization Name | MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA |
| Practice Address |
93 Broadlawn Ardmore OK 73401-6337 |
| Mailing Address |
Po Box 189 Ardmore OK 73402-0189 |
| Practice Telephone | 5802235070 |
| Practice Fax Number | 5802235617 |
| Mailing Telephone | 5802235070 |
| Mailing Fax Number | 5802335617 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2007-12-13 |
| 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 | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| 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 |
| 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 |
| 1073509022 | Mental Health Services of Southern Oklahoma | Case Management | 2530 S Commerce St, Building B, Ardmore, OK 73401-5519 | 2005-09-26 |
| 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 |
| Street Address |
93 BROADLAWN |
| City | ARDMORE |
| State | OK |
| Zip Code | 73401-6337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659530681 | Darla Beth Lyons | Registered Nurse | 93 Broadlawn, Ardmore, OK 73401 | 2008-06-05 |
| 1376712950 | John Elgin Rudd | Counselor | 93 Broadlawn, Ardmore, OK 73401 | 2008-02-27 |
| 1174791255 | Carolyn Elaine Reynolds | Counselor | 93 Broadlawn, Ardmore, OK 73401 | 2008-02-12 |
| 1932388584 | Vincent William Mayo | Counselor | 93 Broadlawn, Ardmore, OK 73401 | 2007-10-31 |
| 1144418278 | Connie S Lamar | Registered Nurse | 93 Broadlawn, Ardmore, OK 73401 | 2007-10-15 |
| 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 | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699290536 | Creative Play & Family Counseling | Clinic/Center | 233 E Lancaster Ave Ste 104, Ardmore, PA 19003-2321 | 2017-08-11 |
| 1144404252 | Mental Health Services of Southern Oklahoma | Clinic/Center | 91 Broadlawn, Ardmore, OK 73401 | 2007-12-26 |
| 1336275247 | Alternative Opportunities Inc. | Clinic/Center | 27 B South West, Suite 100 & 200, Ardmore, OK 73401 | 2007-02-26 |
| 1912053612 | Lighthouse Behavioral Wellness Centers | Clinic/Center | 2530 S Commerce, Bldg B, Ardmore, OK 73401 | 2007-01-26 |
| 1083786719 | Southern Oklahoma Treatment Services, Inc. | Clinic/Center | 905 Holiday Dr, Ardmore, OK 73401-1216 | 2006-11-15 |
| 1790887602 | Oklahoma Families First Inc | Clinic/Center | 1301 Kiowa St, Ardmore, OK 73401-2280 | 2006-09-01 |
| 1922646678 | Karlee Craddock Pllc | Clinic/Center | 301 W Main St Ste 202, Ardmore, OK 73401-6322 | 2019-12-12 |
| 1285168021 | Yco Tulsa, Inc | Clinic/Center | 1301 Kiowa St, Ardmore, OK 73401-2280 | 2017-04-19 |
| 1063806958 | Yco Tulsa, Inc. | Clinic/Center | 115 W Broadway St, Suites 401 A and C, Ardmore, OK 73401-6205 | 2015-03-27 |
| 1568722379 | Lynch Family Services LLC | Clinic/Center | 333 W Main St, Suite 260, Ardmore, OK 73401-6326 | 2012-05-26 |
| Find all providers in ARDMORE | ||||
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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.