NPIMap

Organization Active NPI

Jim Taliaferro CMHC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Duncan, OK
National Provider Identifier
1972648004
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
0005111 Issued in OK
Legal business name
JIM TALIAFERRO CMHC
Practice address
411 Fowler Dr
Duncan, OK 73533-2336
Phone
(580) 248-5780
Fax
(580) 353-3202
NPI assigned
Feb 20, 2007
Last updated
Jan 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Ms. Terri Lee, LPC
Title
Executive Director
Phone
(580) 250-2640

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 0005111 OK Primary

Addresses

Primary practice location

411 Fowler Dr
Duncan, OK 73533-2336

Mailing address

411 Fowler Dr
Duncan, OK 73533-2336
Phone (580) 248-5780

Other identifiers 2

IdentifierTypeStateIssuer
100706940CMedicaidOK
100706940JMedicaidOK

National Provider Directory

National Provider Directory
Tax ID family
Carl Albert Comm Ment H141 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

411 Fowler Dr
Duncan, OK 73533

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1972648004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 FOWLER DR",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735332336",
            "telephone_number": "580-248-5780",
            "fax_number": "580-353-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 FOWLER DR",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735332336",
            "telephone_number": "580-248-5780",
            "fax_number": "580-353-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIM TALIAFERRO CMHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "580-250-2640",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "OK",
            "license": "0005111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100706940C",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100706940J",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncan, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.