NPIMap

Organization Active NPI

Sequelcare of Oklahoma, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Idabel, OK
National Provider Identifier
1740344290
Registry record updated Dec 31, 2012
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
SEQUELCARE OF OKLAHOMA, LLC
Practice address
411 S Central Ave
Idabel, OK 74745-6059
Phone
(580) 286-5721
NPI assigned
Dec 20, 2006
Last updated
Dec 31, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

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

Authorized official

Name
Dorothy Metcalf, MSW, LCSW, LADC
Title
Exec Dir
Phone
(580) 298-2830

Specialties & licenses 1

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

Addresses

Primary practice location

411 S Central Ave
Idabel, OK 74745-6059

Mailing address

PO Box 1030
Antlers, OK 74523-1030
Phone (580) 298-2830

Other identifiers 1

IdentifierTypeStateIssuer
100744370NMedicaidOK

National Provider Directory

National Provider Directory
Tax ID family
Camelot Community Services of Oklahoma LLC36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356912000000",
    "number": "1740344290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1030",
            "city": "ANTLERS",
            "state": "OK",
            "postal_code": "745231030",
            "telephone_number": "580-298-2830",
            "fax_number": "580-298-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S CENTRAL AVE",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "747456059",
            "telephone_number": "580-286-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUELCARE OF OKLAHOMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2012-12-31",
        "status": "A",
        "authorized_official_last_name": "METCALF",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_title_or_position": "EXEC DIR",
        "authorized_official_telephone_number": "580-298-2830",
        "authorized_official_credential": "MSW, LCSW, LADC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100744370N",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idabel, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; 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.