NPIMap

Organization Active NPI

Mental Health Services of Southern Oklahoma

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Marietta, OK
National Provider Identifier
1295871499
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA
Practice address
200 Wanda St
Marietta, OK 73448
Phone
(580) 223-5070
Fax
(580) 223-5617
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Authorized official

Name
Robert E Lee, LCSW
Title
Executive Director
Phone
(580) 223-5070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

200 Wanda St
Marietta, OK 73448

Mailing address

PO Box 189
Ardmore, OK 73402-0189
Phone (580) 223-5070

Other identifiers 1

IdentifierTypeStateIssuer
100728830 IMedicaidOK

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 24

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

View all 24

Locations

200 Wanda St
Marietta, OK 73448
Phone (580) 276-1542

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1295871499",
    "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": "580-223-5070",
            "fax_number": "580-223-5617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WANDA ST",
            "city": "MARIETTA",
            "state": "OK",
            "postal_code": "73448",
            "telephone_number": "580-223-5070",
            "fax_number": "580-223-5617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "580-223-5070",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100728830 I",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.