SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC (NPI# 1740384049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740384049 |
| Entity Type | Organization |
| Organization Name | SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC |
| Other Organization Name | SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM |
| Practice Address |
6125 S Sheridan Rd Suite D Tulsa OK 74133-4056 |
| Mailing Address |
6262 S Sheridan Rd Tulsa OK 74133-4055 |
| Practice Telephone | 9185853083 |
| Practice Fax Number | 9184922075 |
| Mailing Telephone | 9184928200 |
| Mailing Fax Number | 9184933268 |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SHARON WORSHAM (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9184928200 |
| 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) |
OK | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Shadow Mountain Behavioral Health System | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316056534 | Shadow Mountain Behavioral Health System, LLC | Clinic/Center | 5350 S Western Ave, Suite 555`, Oklahoma City, OK 73109-4520 | 2006-08-30 |
| 1841304250 | Shadow Mountain Behavioral Health System, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2801 Venture Dr, Norman, OK 73069-8215 | 2006-08-19 |
| 1982005971 | Shadow Mountain Behavioral Health System, LLC | Psychiatric Hospital | 6262 S Sheridan Rd, Tulsa, OK 74133-4055 | 2014-09-09 |
| 1902224801 | Shadow Mountain Behavioral Health System, LLC | Psychiatric Hospital | 6262 S Sheridan Rd, Tulsa, OK 74133-4055 | 2014-03-29 |
| 1184941148 | Shadow Mountain Behavioral Health System, LLC | Psychiatric Residential Treatment Facility | 6262 S Sheridan Rd, Tulsa, OK 74133-4055 | 2010-04-29 |
| 1528383841 | Shadow Mountain Behavioral Health System, LLC | Pharmacy | 1027 E 66th Pl, Tulsa, OK 74136-3701 | 2010-03-30 |
| 1285867713 | Shadow Mountain Behavioral Health System, LLC | Psychiatric Residential Treatment Facility | 4012 E 35th St, Tulsa, OK 74135-4528 | 2009-09-01 |
| 1831304351 | Shadow Mountain Behavioral Health System, LLC | Psychiatric Residential Treatment Facility | 6262 S Sheridan Rd, Tulsa, OK 74133-4055 | 2007-05-10 |
| 1659475952 | Shadow Mountain Behavioral Health System, LLC | Clinic/Center | 6262 S Sheridan Rd, Tulsa, OK 74133-4055 | 2006-09-08 |
| 1003923442 | Shadow Mountain Behavioral Health System, LLC | Psychiatric Residential Treatment Facility | 6262 S Sheridan Rd, Tulsa, OK 74133-4055 | 2006-08-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC | 367 S. Gulph Road, King of Prussia, PA 19406 |
| Street Address |
6125 S SHERIDAN RD SUITE D |
| City | TULSA |
| State | OK |
| Zip Code | 74133-4056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326088683 | Riley Powell | Chiropractor | 6125 S Sheridan Rd, Suite H, Tulsa, OK 74133-4053 | 2006-06-07 |
| 1609023860 | Cynthia Rorie | Counselor | 6125 S Sheridan Rd, Suite D, Tulsa, OK 74133-4056 | 2008-08-19 |
| 1508022302 | Brandyn Willis | Counselor | 6125 S Sheridan Rd, Suite D, Tulsa, OK 74133-4056 | 2008-07-31 |
| 1104099613 | Powell Chiropractic, P.C. | Chiropractor | 6125 S Sheridan Rd, Suite H, Tulsa, OK 74133-4056 | 2008-04-04 |
| 1275715500 | Kristi Johnson | Counselor | 6125 S Sheridan Rd, Tulsa, OK 74133-4056 | 2007-11-28 |
| 1174716393 | Sharon Nichols | Counselor | 6125 S Sheridan Rd, Suite D, Tulsa, OK 74133-4056 | 2007-08-21 |
| 1821281189 | Serena Stoalabarger | Counselor | 6125 S Sheridan Rd, Suite D, Tulsa, OK 74133-4056 | 2007-08-21 |
| 1093911216 | Larry Lynch | Social Worker | 6125 S Sheridan Rd, Tulsa, OK 74133-4056 | 2007-06-25 |
| 1700082922 | Stephanie Spillers | Counselor | 6125 S Sheridan Rd, Tulsa, OK 74133-4056 | 2007-06-25 |
| 1043416266 | Charley Farley | Social Worker | 6125 S Sheridan Rd, Tulsa, OK 74133-4056 | 2007-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932725058 | Economy Pharmacy | Pharmacy | 10120 E 91st, Tulsa, OK 74133 | 2020-06-24 |
| 1710539424 | Fresenius Medical Care Tulsa, LLC | Clinic/Center | 9310 East 91st Street, Tulsa, OK 74133 | 2019-07-12 |
| 1003382060 | Carefirst Pharmacy Tulsa, Inc. | Pharmacy | 6214 S. Sheridan Rd, Tulsa, OK 74133 | 2018-10-17 |
| 1003397332 | Adekemi Taiwo | Nurse Practitioner | Hillcrest South Medical Plaza, 8803 S. 101 St E. Ave. Suite 350, Tulsa, OK 74133 | 2018-08-24 |
| 1346732013 | Lauren Nichols | Dentist | 7707 E 111th St Ste 105, Tulsa, OK 74133 | 2018-05-30 |
| 1699264259 | Courtney N Johnson, Pllc | Dentist | 7901 S Sheridan Rd Unit A, Tulsa, OK 74133 | 2018-05-08 |
| 1417464199 | Tulsa Medical and Orthopedic Center PC | Family Medicine | 8165 S Mingo Rd Ste 200, Tulsa, OK 74133 | 2018-01-04 |
| 1013421023 | Susan C. Willard, Do, Pllc | Family Medicine | 6532 E. 71st Street, Suite 150, Tulsa, OK 74133 | 2017-11-29 |
| 1851800825 | Seyva LLC | Clinic/Center | 8522 S 70th E Ave, Tulsa, OK 74133 | 2017-09-21 |
| 1477072031 | Amanda Dawn Long | Registered Nurse | 10507 E 91st St Ste 310, Tulsa, OK 74133 | 2017-09-14 |
| Find all providers in zip 74133 | ||||
| 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 |
|---|---|---|---|---|
| 1649870742 | Sequelcare of Oklahoma, LLC | Clinic/Center | 6218 S Lewis Ave Ste 118, Tulsa, OK 74136-1018 | 2020-10-28 |
| 1295342046 | Integrative Healthcare Solutions LLC | Clinic/Center | 2227 E 8th St, Tulsa, OK 74104-3237 | 2020-09-25 |
| 1659904076 | Grand Lake Mental Health Center Inc | Clinic/Center | 4815 S Harvard Ave Ste 420, Tulsa, OK 74135-3068 | 2020-02-13 |
| 1487201133 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 7307 S Yale Ave, Suite 101, Tulsa, OK 74136-7134 | 2019-08-19 |
| 1235694803 | Genes Progeny | Clinic/Center | 9243 S 91st East Ave, Tulsa, OK 74133-5645 | 2019-02-07 |
| 1588136758 | Grand Lake Mental Health Center Inc | Clinic/Center | 4815 S. Harvard, Suite 420, Tulsa, OK 74135-3068 | 2018-12-27 |
| 1730606153 | Consolation Counseling Services, LLC | Clinic/Center | 2326 S Garnett Rd Ste K, Tulsa, OK 74129-5118 | 2017-08-25 |
| 1326569252 | Gilead Counseling Center LLC | Clinic/Center | 2448 E 81st St Ste 2045, Tulsa, OK 74137-4271 | 2017-06-30 |
| 1578580916 | State of Oklahoma | Clinic/Center | 2323 S Harvard Ave, Tulsa, OK 74114-3301 | 2006-07-15 |
| 1013527944 | Shanna Eischen Consulting and Counseling LLC | Clinic/Center | 6308 E 15th St Ste 2c, Tulsa, OK 74112-6411 | 2020-08-05 |
| Find all providers in TULSA | ||||
Please comment or provide details below to improve the information on SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC.
| 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.