EXCEL MENTAL HEALTH SERVICES, LLC (NPI# 1104295500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104295500 |
| Entity Type | Organization |
| Organization Name | EXCEL MENTAL HEALTH SERVICES, LLC |
| Other Organization Name | EXCEL MHS, LLC |
| Practice Address |
513 S Willow St Pauls Valley OK 73075-3849 |
| Mailing Address |
Po Box 826 Pauls Valley OK 73075-0826 |
| Practice Telephone | 4059262085 |
| Practice Fax Number | 4059262089 |
| Mailing Telephone | 4059262085 |
| Mailing Fax Number | 4059262089 |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2015-09-16 |
| Authorized Official Name | MR. RANDY HUGH GARDENHIRE (CEO) |
| Authorized Official Telephone | 5803993071 |
| Authorized Official Credential | MS, LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 106H00000X | Marriage & Family Therapist | 1147 | OK | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
5643 | OK | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Excel MHS, LLC | Doing Business As Name - Organization |
| Street Address |
513 S WILLOW ST |
| City | PAULS VALLEY |
| State | OK |
| Zip Code | 73075-3849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013438191 | Catoya Taneil Mitchell | Counselor | 513 S Willow St, Pauls Valley, OK 73075-3849 | 2017-06-29 |
| 1013447333 | Angela Marie Farmer | Counselor | 513 S Willow St, Pauls Valley, OK 73075-3849 | 2017-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194292490 | Jennifer Lynn Reicosky | Counselor | 513 Willow, Pauls Valley, OK 73075 | 2018-10-25 |
| 1336467299 | Fred Lee Mcginn Iv | Counselor | Atlc, 111 Arrowhead Dr., Pauls Valley, OK 73075 | 2010-05-17 |
| 1447435433 | Amanda Marie Hammonds | Physical Therapist | 37915 Ecr 1530, Pauls Valley, OK 73075 | 2008-01-08 |
| 1255533873 | Ladonna L.l. Lynnell Luckey | Counselor | 111 Arrowhead Drive, Adolescent Transitional Living Center, Pauls Valley, OK 73075 | 2007-06-05 |
| 1144369026 | James Ray Ward | Dentist | 112 N Oak, Pauls Valley, OK 73075 | 2007-02-06 |
| 1700953247 | Stanley Family Chiropractic PC | Chiropractor | 1555 W Grant, Pauls Valley, OK 73075 | 2006-11-29 |
| 1659458412 | Woodlawn, LLC | Respite Care | 1413 S. Chickasha, Pauls Valley, OK 73075 | 2006-11-01 |
| 1689750457 | Dana J Martin Dds PC | Dentist | 1600 Airline Road, Pauls Valley, OK 73075 | 2006-10-27 |
| 1609963800 | State of Oklahoma Dept. of Human Services | Pharmacy | Rt 1 Box 44a, Pauls Valley, OK 73075 | 2006-10-07 |
| 1295828895 | State of Oklahoma Dept. of Human Services | Intermediate Care Facility, Mentally Retarded | Rt. 1 Box 44-a, Pauls Valley, OK 73075 | 2006-10-02 |
| Find all providers in zip 73075 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255533873 | Ladonna L.l. Lynnell Luckey | Counselor | 111 Arrowhead Drive, Adolescent Transitional Living Center, Pauls Valley, OK 73075 | 2007-06-05 |
| 1649212093 | Sharlotte Renee Burkes Gilles | Counselor | 109 Willow, Pauls Valley, OK 73075 | 2006-06-11 |
| 1790732238 | Mary T. Hope | Counselor | 37050 Highway 19, Pauls Valley, OK 73075-8678 | 2006-05-30 |
| 1417382615 | Thomas Taylor Moore | Counselor | 111 Arrowhead Dr, Pauls Valley, OK 73075-5301 | 2013-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437758224 | Taylor Christine Clinton | Counselor | 3838 Nw 36th St Ste 300, Oklahoma City, OK 73112-2970 | 2020-10-22 |
| 1093328346 | Kathryn Glover Bishop | Counselor | 5921 E 97th St, Tulsa, OK 74137-5011 | 2020-08-26 |
| 1528670239 | Grand Lake Therapeutics LLC | Counselor | 1441 Lakeside Dr, Grove, OK 74344-4223 | 2020-08-24 |
| 1164034898 | Heather Jean Miller | Counselor | 1320 E 9th St Ste 8, Edmond, OK 73034-5773 | 2020-08-24 |
| 1225640337 | Michelle Davis Gannaway | Counselor | 13315 N Coltrane Rd, Edmond, OK 73013-8257 | 2020-08-19 |
| 1841801321 | Yolanda Cummings Counseling, Inc. | Counselor | 24900 County Road 1512, Ada, OK 74820-0994 | 2020-08-10 |
| 1518585595 | Twelfth House Wellness LLC | Counselor | 1929 Nw 29th St, Oklahoma City, OK 73106-1019 | 2020-07-07 |
| 1396369286 | Advocate for Mental Health Services LLC | Counselor | 1300 Mcgee Dr Ste 103, Norman, OK 73072-5858 | 2020-06-05 |
| 1639791221 | Santa Gladys Velez | Counselor | 1215 Crossroads Blvd Ste 212, Norman, OK 73072-3391 | 2020-05-18 |
| 1801415898 | Powerful Design Consulting, LLC | Counselor | 122 E Woodcraft Rd, Bennington, OK 74723-1833 | 2020-04-10 |
| Find all providers with the same taxonomy | ||||
| City | PAULS VALLEY |
| Zip Code | 73075 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.