NPIMap

Organization Active NPI

Shadow Mountain Behavioral Health System, LLC

Doing business as Shadow Mountain Behavioral Health System

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oklahoma City, OK
National Provider Identifier
1316056534
Registry record updated Jul 21, 2022
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
SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC
Doing business as
Shadow Mountain Behavioral Health System
Practice address
5350 S Western Ave
Suite 555
Oklahoma City, OK 73109-4520
Phone
(405) 631-4567
Fax
(405) 996-2113
NPI assigned
Aug 30, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Sharon Worsham
Title
Chief Executive Officer
Phone
(918) 492-8200

Specialties & licenses 1

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

Addresses

Primary practice location

5350 S Western Ave
Suite 555
Oklahoma City, OK 73109-4520

Mailing address

6262 S Sheridan Rd
Tulsa, OK 74133-4055
Phone (918) 492-8200

Other names 1

  • Shadow Mountain Behavioral Health System Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Shadow Mountain Behavioral Health System15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

5350 S Western Ave
Ste 555
Oklahoma City, OK 73109
Phone (405) 631-4567

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1316056534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6262 S SHERIDAN RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334055",
            "telephone_number": "918-492-8200",
            "fax_number": "918-493-3268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 S WESTERN AVE",
            "address_2": "SUITE 555",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731094520",
            "telephone_number": "405-631-4567",
            "fax_number": "405-996-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADOW MOUNTAIN BEHAVIORAL HEALTH SYSTEM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WORSHAM",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "918-492-8200"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shadow Mountain Behavioral Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.