Modern Mental Health

Primary specialty

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

Legal business name

MODERN MENTAL HEALTH

Practice address

609 S Redwood Ave
Broken Arrow, OK 74012-4516

Phone

(918) 836-0239

NPI assigned

Nov 29, 2017

Organization subpart

No

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

Authorized official

Name

Krystle HahnNPI 1124479480

Title

Executive Director

Phone

(918) 815-6567

Specialties & licenses 1

Addresses

Practitioners 1

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

• Krystle Hahn

  • Case Manager/Care Coordinator
  • Tulsa, OK
  • NPI 1124479480
  NPD Authorized official

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511913600000",
    "number": "1700390671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 S REDWOOD AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 S REDWOOD AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124516",
            "telephone_number": "918-836-0239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-29",
        "last_updated": "2017-11-29",
        "status": "A",
        "authorized_official_last_name": "HAHN",
        "authorized_official_first_name": "KRYSTLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "918-815-6567"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Mitchell
• Stacy Lynn Mitchell, LPC
• Tiffany E Mitchell, MS
• MK Diagnostic Ultrasounds LLC
• Mobile Physician'S Office LLC
• Samirah Mohamad, DDS
• Shelby Nicole Mondloch, OTA/L
• Katherine Monette, DPH
• Robert Blaine Mongrain Jr., DMD
• Bradley Russell Mons, D.O.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Broken Arrow, OK
• Providers in Broken Arrow, 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 Nov 29, 2017; 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.