MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA (NPI# 1972659910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972659910 |
| Entity Type | Organization |
| Organization Name | MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA |
| Practice Address |
603 S 1st St Madill OK 73446-3807 |
| Mailing Address |
Po Box 189 Ardmore OK 73402-0189 |
| Practice Telephone | 5802235070 |
| Practice Fax Number | 5802235617 |
| Mailing Telephone | 5802235070 |
| Mailing Fax Number | 5802235617 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2007-12-12 |
| 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 |
| 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 |
| 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 |
603 S 1ST ST |
| City | MADILL |
| State | OK |
| Zip Code | 73446-3807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992909147 | Edward Ryan Pense | Counselor | 603 S 1st St, Madill, OK 73446-3807 | 2007-06-12 |
| 1679619886 | Mental Health Services of Southern Oklahoma | Case Management | 603 S 1st St, Madill, OK 73446 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104306943 | Jennifer Duncan | Case Manager/Care Coordinator | 605 S. 1st, Madill, OK 73446 | 2018-08-21 |
| 1710228853 | Southeastern Oklahoma Family Services, Inc. | Community/Behavioral Health | 605 1st Street, Madill, OK 73446 | 2013-03-14 |
| 1285975581 | Madill Dental Company | Dentist | 804 S 1st St Suite C, Madill, OK 73446 | 2013-03-12 |
| 1174812879 | Lori Ann Black | Counselor | 109 South 1st, Madill, OK 73446 | 2011-04-04 |
| 1598090318 | Marshall County Ems District | Ambulance | Four Hospital Drive, Madill, OK 73446 | 2009-10-13 |
| 1598969800 | Tanya L Magness | Counselor | 300 E Wolf St, Madill, OK 73446 | 2007-06-12 |
| 1629100524 | Stacy James Rendon | Occupational Therapy Assistant | 210 Brookside Drive, Madill, OK 73446 | 2007-03-09 |
| 1194881367 | Carren D Tshirlig | Occupational Therapist | Hwy 99 S, Madill, OK 73446 | 2006-12-29 |
| 1912000886 | Courtney Thomas | Physical Therapy Assistant | 310 Brookside Dr., Madill, OK 73446 | 2006-09-06 |
| 1700993797 | Wapiti Orthopedics PC | Orthopaedic Surgery | #1 Hospital Drive, Madill, OK 73446 | 2006-08-24 |
| Find all providers in zip 73446 | ||||
| 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 |
|---|---|---|---|---|
| 1740340157 | Providence Service Corporation of Oklahoma | Clinic/Center | 105 Plaza, Madill, OK 73446-2248 | 2006-12-08 |
| 1669866547 | Yco Tulsa, Inc. | Clinic/Center | 605 S 1st St, Suite A, Madill, OK 73446-3807 | 2015-03-27 |
| 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 |
| 1649870890 | M & M Counseling Group, LLC | Clinic/Center | 207 S Czech Hall Rd, Yukon, OK 73099-6851 | 2020-10-27 |
| 1992303721 | Misty Watkins | Clinic/Center | 1601 Sw Parkridge Blvd Ste 200, Lawton, OK 73505-7564 | 2020-10-14 |
| 1295342046 | Integrative Healthcare Solutions LLC | Clinic/Center | 2227 E 8th St, Tulsa, OK 74104-3237 | 2020-09-25 |
| 1235744020 | Strength of A Warrior Counseling Services LLC | Clinic/Center | 4516 Se 25th St, Del City, OK 73115-4114 | 2020-09-09 |
| 1609488253 | Alexie Foster, LLC | Clinic/Center | 16802 S 301st West Ave, Bristow, OK 74010-2265 | 2020-08-17 |
| 1306455068 | Restore Family Counseling, LLC | Clinic/Center | 100 W. Wilshire, Suite #c3, Oklahoma City, OK 73116 | 2020-07-29 |
| 1245855857 | Dragonfly Psychotherapy | Clinic/Center | 2942 Ne Orlie Dr, Forest Park, OK 73121-2436 | 2020-06-09 |
| 1508480872 | Maria Nancy Martinez | Clinic/Center | 5350 S Western Ave Ste 217, Oklahoma City, OK 73109-4525 | 2020-06-03 |
| 1649894015 | Miranda Rackers | Clinic/Center | 1308 E Mckinley Ave, Sapulpa, OK 74066-4824 | 2020-06-02 |
| Find all providers with the same taxonomy | ||||
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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.