MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA (NPI# 1871751818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871751818 |
| Entity Type | Organization |
| Organization Name | MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA |
| Other Organization Name | MENTAL HEALTH AND SUBSTANCE ABUSE CENTERS OF SOUTHERN OKLAHOMA |
| Practice Address |
209 E Wilson St Tishomingo OK 73460-2200 |
| Mailing Address |
Po Box 189 Ardmore OK 73402-0189 |
| Practice Telephone | 5803713019 |
| Mailing Telephone | 5802235070 |
| Mailing Fax Number | 5802235617 |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2008-05-27 |
| Authorized Official Name | ROBERT E LEE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5802235070 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200129610 E | 05 |
| Other Name | Type Code |
|---|---|
| Mental Health and Substance Abuse Centers of Southern Oklahoma | Doing Business As Name - Organization |
| 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 |
209 E WILSON ST |
| City | TISHOMINGO |
| State | OK |
| Zip Code | 73460-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780867812 | Mental Health Services of Southern Oklahoma | Clinic/Center | 209 E Wilson St, Tishomingo, OK 73460-2200 | 2007-12-12 |
| 1437428554 | Heather Louise Littrell | Case Manager/Care Coordinator | 209 E Wilson St, Tishomingo, OK 73460-2200 | 2011-12-19 |
| 1124286166 | Mental Health Services of Southern Oklahoma | Community/Behavioral Health | 209 E Wilson St, Tishomingo, OK 73460-2200 | 2008-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912380742 | Lori Pigg | Speech-Language Pathologist | 508 N. Neshoba, Tishomingo, OK 73460 | 2015-06-29 |
| 1407241748 | Brittany Walker | Case Management | 850 E. Highway 22, Tishomingo, OK 73460 | 2015-04-03 |
| 1427460641 | Elizabeth Mcdonald | Counselor | 512 East 24th, Tishomingo, OK 73460 | 2014-05-22 |
| 1619387131 | Sheri Slaughter | Counselor | 102 N. Neshoba, Tishomingo, OK 73460 | 2014-05-06 |
| 1336559848 | Heather Marlatt | Counselor | 102 North Neshoba, Tishomingo, OK 73460 | 2014-05-06 |
| 1811231939 | Wanda Luann Beesley Gray | Emergency Medical Technician, Paramedic | 3100 E St Hwy 78, Tishomingo, OK 73460 | 2012-11-15 |
| 1497014724 | Jessica Kay Johnston | Counselor | Outpatient Services-tishomingo; 817 E. 6th St., Strong Family Development, Tishomingo, OK 73460 | 2012-05-07 |
| 1487910949 | Rhonda Gayle Harrison | Counselor | 817 E. 6th St., Medical Family Therapy, Tishomingo, OK 73460 | 2012-04-09 |
| 1265704183 | Parks Family Dental | Preferred Provider Organization | 1520 E. Main Street, Tishomingo, OK 73460 | 2012-02-08 |
| 1770852295 | Gina Marice Frazier | Social Worker | Outpatient Services- Tishomingo, 817 E. 6th St., Tishomingo, OK 73460 | 2011-12-29 |
| Find all providers in zip 73460 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578768164 | Counseling, Inc. | Community/Behavioral Health | 201 N Neshoba St, Tishomingo, OK 73460-1741 | 2007-06-15 |
| 1568000966 | Southern Oklahoma Treatment Services, Inc. | Community/Behavioral Health | 512 E 24th St, Tishomingo, OK 73460-3214 | 2019-12-16 |
| 1891110714 | Southeastern Oklahoma Family Services, Inc | Community/Behavioral Health | 512 E 24th St, Tishomingo, OK 73460-3214 | 2014-02-28 |
| 1164771366 | Pennington Creek Life House | Community/Behavioral Health | 801 E Main St, Tishomingo, OK 73460-2351 | 2012-09-04 |
| 1831464304 | Pennington Creek Lifehouse | Community/Behavioral Health | 801 E Main St, Tishomingo, OK 73460-2351 | 2012-03-16 |
| 1568746584 | Hartsell Psychological Services | Community/Behavioral Health | 504 E 24th St, Tishomingo, OK 73460-3214 | 2011-10-10 |
| 1730462185 | Lighthouse Behavioral Wellness Centers | Community/Behavioral Health | 108 W Main St, Tishomingo, OK 73460-1723 | 2011-09-22 |
| 1407177306 | Hartsell Psychological Services, Inc | Community/Behavioral Health | 504 E 24th St, Tishomingo, OK 73460-3214 | 2010-06-15 |
| 1124286166 | Mental Health Services of Southern Oklahoma | Community/Behavioral Health | 209 E Wilson St, Tishomingo, OK 73460-2200 | 2008-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073623 | Keonte Criswell | Community/Behavioral Health | 11530 Andover Ct, Oklahoma City, OK 73130-8217 | 2020-11-05 |
| 1427656909 | Against All Odds Youth and Family Services | Community/Behavioral Health | 2701 Nw 185th St, Edmond, OK 73012-9795 | 2020-10-15 |
| 1730798117 | Healing Minds Counseling LLC | Community/Behavioral Health | 5300 N Meridian Ave Ste 11, Oklahoma City, OK 73112-2179 | 2020-07-30 |
| 1477170322 | Glostars LLC | Community/Behavioral Health | 19704 Vivace Dr, Edmond, OK 73012-5232 | 2020-06-26 |
| 1780201798 | Canadian County Collaborative LLC | Community/Behavioral Health | 1703 Professional Cir Ste 201, Yukon, OK 73099-6498 | 2020-06-26 |
| 1235754458 | New Life Counseling Center | Community/Behavioral Health | 1206 N Hwy 81, Duncan, OK 73533-1790 | 2020-06-12 |
| 1770108946 | Meadow Hazelhoff Counseling, LLC | Community/Behavioral Health | 9524 Conners Way, Mcloud, OK 74851-8668 | 2020-06-12 |
| 1407477920 | Keetoowah Economic Development | Community/Behavioral Health | 16414 W 760 Rd, Tahlequah, OK 74464-1675 | 2020-05-06 |
| 1992336481 | Share More Ctc, LLC | Community/Behavioral Health | 2000 N Broadway St Ste B, Moore, OK 73160-4416 | 2020-02-03 |
| 1356981138 | Grand Lake Mental Health Center Inc | Community/Behavioral Health | 2225 N Union, Ponca City, OK 74601-1536 | 2020-01-09 |
| Find all providers with the same taxonomy | ||||
| City | TISHOMINGO |
| Zip Code | 73460 |
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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.