NPIMap

Organization Active NPI

Mental Health Service of Southern Oklahoma

  • Community/Behavioral Health Agency
  • Durant, OK
National Provider Identifier
1093349003
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MENTAL HEALTH SERVICE OF SOUTHERN OKLAHOMA
Practice address
2425 W University Blvd
Durant, OK 74701-2942
Phone
(580) 924-7330
Fax
(580) 924-2739
NPI assigned
Feb 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mauna Lia
Title
Administrative Assistant
Phone
(580) 319-7305

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2425 W University Blvd
Durant, OK 74701-2942

Mailing address

PO Box 189
Ardmore, OK 73402-0189
Phone (580) 319-7305

Other identifiers 1

IdentifierTypeStateIssuer
100728830MedicaidOK

National Provider Directory

National Provider Directory
Tax ID family
Mental Health Services65 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582848000000",
    "number": "1093349003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734020189",
            "telephone_number": "580-319-7305",
            "fax_number": "580-319-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 W UNIVERSITY BLVD",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747012942",
            "telephone_number": "580-924-7330",
            "fax_number": "580-924-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH SERVICE OF SOUTHERN OKLAHOMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-28",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A",
        "authorized_official_last_name": "LIA",
        "authorized_official_first_name": "MAUNA",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "580-319-7305"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100728830",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durant, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.