Psychiatric and Addiction Centered Medicine LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PSYCHIATRIC AND ADDICTION CENTERED MEDICINE LLC

Practice address

109 E Main St Unit D
Stigler, OK 74462-2704

Phone

(918) 438-5477

NPI assigned

Jan 11, 2024

Organization subpart

No

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

Authorized official

Name

Kimberly Smith

Title

Credentialing Contact

Phone

(405) 812-6562

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leigh Nicole Moore

  • Addiction (Substance Use Disorder) Counselor
  • Oklahoma City, OK
  • NPI 1316512114

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Shauna Lyn Andrews, LPC

  • Professional Counselor
  • Ada, OK
  • NPI 1942710710
  Medicare reassignment Care Compare group
• Chasity Jane Butler, PA-C

  • Physician Assistant
  • Stigler, OK
  • NPI 1619273877
  Medicare reassignment Care Compare group
• Ashley Laniece Loftis, PA-C

  • Medical Physician Assistant
  • Clarendon, AR
  • NPI 1164897823

  OK

  Medicare reassignment Care Compare group
• Codie Jordan Vassar, M.D

  • Psychiatry Physician
  • Kenosha, WI
  • NPI 1538690995

  OK

  Medicare reassignment NPD
• Shannon Lee White

  • Psychiatric/Mental Health Nurse Practitioner
  • Stigler, OK
  • NPI 1952241804
  Medicare reassignment
• Mehle Erin Armstrong I, MA, LPC

  • Professional Counselor
  • Oklahoma City, OK
  • NPI 1033649207
  NPD

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710201600000",
    "number": "1407627029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E MAIN ST UNIT D",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744622704",
            "telephone_number": "918-438-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E MAIN ST UNIT D",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744622704",
            "telephone_number": "918-438-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC AND ADDICTION CENTERED MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CREDENTIALING CONTACT",
        "authorized_official_telephone_number": "405-812-6562"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eva L Phillips
• PM Medical LLC
• Crystal Portugal
• Tara Potts, APRN
• Kaitlen Elizabeth Pryor
• Amanda Rainbolt
• Carrie Linda Randall, P.A.-C
• Leslie Ratliff
• Melissa Reading, BA
• Beth Reese, LMSW

• Mental Health Clinic/Center (Including Community Mental Health Center) in Stigler, OK
• Providers in Stigler, OK by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.