NPIMap

Organization Active NPI

Waynoka Mental Health Authority

Doing business as Northwest Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Waynoka, OK
National Provider Identifier
1376991737
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
5433-P Issued in OK
Legal business name
WAYNOKA MENTAL HEALTH AUTHORITY
Doing business as
Northwest Treatment Center
Practice address
1095 Nickerson St
Waynoka, OK 73860-1252
Phone
(580) 824-0674
Fax
(580) 824-0676
NPI assigned
May 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2016

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

Authorized official

Name
Clarissa M Fifield, LCSW PROVISIONALNPI 1205320140
Title
Counselor
Phone
(580) 824-0674

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 5433-P OK Primary

Addresses

Primary practice location

1095 Nickerson St
Waynoka, OK 73860-1252

Mailing address

PO Box 135
Waynoka, OK 73860-0135
Phone (580) 824-0674

Other names 1

  • Northwest Treatment Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northwest Treatment Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 9

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": "1464220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464220800000",
    "number": "1376991737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 135",
            "city": "WAYNOKA",
            "state": "OK",
            "postal_code": "738600135",
            "telephone_number": "580-824-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 NICKERSON ST",
            "city": "WAYNOKA",
            "state": "OK",
            "postal_code": "738601252",
            "telephone_number": "580-824-0674",
            "fax_number": "580-824-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNOKA MENTAL HEALTH AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-26",
        "last_updated": "2016-05-26",
        "status": "A",
        "authorized_official_last_name": "FIFIELD",
        "authorized_official_first_name": "CLARISSA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "580-824-0674",
        "authorized_official_credential": "LCSW PROVISIONAL"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "OK",
            "license": "5433-P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waynoka, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.