Jaime Montgomery

Individual provider Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Mead, OK

NPI 1124705876 · NPPES record last updated Aug 22, 2024

Key facts

NPI
1124705876
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Practice address
5912 US Hwy 70
Mead, OK 73449
Phone
(580) 745-9083
NPI assigned
Jul 3, 2023
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Oklahoma Treatment Services, Inc. Mental Health (Including Community Mental Health Center) Past
since Jul 9, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Yes

Addresses

Primary practice location

5912 US Hwy 70
Mead, OK 73449

Mailing address

226 E Monterey St
Denison, TX 75021-6622

Other providers in Mead, OK

All providers in Mead, OK · Mental Health Clinic/Center (Including Community Mental Health Center) in Oklahoma

Sources for this page

Verify at the official NPI Registry.