PROVIDENCE SERVICE CORPORATION OF OKLAHOMA (NPI# 1235299645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235299645 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE SERVICE CORPORATION OF OKLAHOMA |
| Other Organization Name | PROVIDENCE OF OKLAHOMA |
| Practice Address |
117 E Main St Hugo OK 74743-6237 |
| Mailing Address |
620 N Craycroft Rd Tucson AZ 85711-1448 |
| Practice Telephone | 5803267477 |
| Practice Fax Number | 5803266400 |
| Mailing Telephone | 5207476600 |
| Mailing Fax Number | 5207476613 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BREEANN MARIE HOERNING (AR AND BILLING MANAGER) |
| Authorized Official Telephone | 5207476600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Providence of Oklahoma | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740340157 | Providence Service Corporation of Oklahoma | Clinic/Center | 105 Plaza, Madill, OK 73446-2248 | 2006-12-08 |
| 1639239023 | Providence Service Corporation of Oklahoma | Clinic/Center | 301 N High St, Antlers, OK 74523-2238 | 2006-12-08 |
| 1407916802 | Providence Service Corporation of Oklahoma | Clinic/Center | 134 N 12th Ave, Durant, OK 74701-4718 | 2006-12-08 |
| 1033279443 | Providence Service Corporation of Oklahoma | Clinic/Center | 4645 W Gore Blvd Ste 5, Lawton, OK 73505-5962 | 2006-12-08 |
| 1487726170 | Providence Service Corporation of Oklahoma | Clinic/Center | 931 Arlington St Ste 2, Ada, OK 74820-4025 | 2006-11-15 |
| 1295154581 | Providence Service Corporation of Oklahoma | Community/Behavioral Health | 116 Se Ave N, Idabel, OK 74745-5234 | 2014-04-15 |
| 1568504553 | Providence Service Corporation of Oklahoma | Case Management | 134 N 12th Ave, Durant, OK 74701-4718 | 2007-02-13 |
| 1003958091 | Providence Service Corporation of Oklahoma | Case Management | 134 N 12th Ave, Durant, OK 74701-4718 | 2007-02-13 |
| 1811039894 | Providence Service Corporation of Oklahoma | Case Management | 931 Arlington St Ste 2, Ada, OK 74820-4025 | 2007-02-13 |
| 1942342944 | Providence Service Corporation of Oklahoma | Case Management | 105 Plaza, Madill, OK 73446-2248 | 2007-02-13 |
| Street Address |
117 E MAIN ST |
| City | HUGO |
| State | OK |
| Zip Code | 74743-6237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548527302 | Linda K Green | Counselor | 117 E Main St, Hugo, OK 74743-6237 | 2012-04-18 |
| 1730453374 | Darnell Hampton | Counselor | 117 E Main St, Hugo, OK 74743-6237 | 2012-02-29 |
| 1912292459 | Judy Kay Strickland | Counselor | 117 E Main St, Hugo, OK 74743-6237 | 2011-06-13 |
| 1376832311 | Tara A Myers | Counselor | 117 E Main St, Hugo, OK 74743-6237 | 2011-03-30 |
| 1801185848 | Janitra D Bostic | Counselor | 117 E Main St, Hugo, OK 74743-6237 | 2011-03-30 |
| 1164721056 | Providence Service Corp | Clinic/Center | 117 E Main St, Hugo, OK 74743-6237 | 2011-03-18 |
| 1144547324 | Jerri S Griffin | Counselor | 117 E Main St, Hugo, OK 74743-6237 | 2010-04-27 |
| 1790008902 | Providence of Oklahoma | Community/Behavioral Health | 117 E Main St, Hugo, OK 74743-6237 | 2010-03-03 |
| 1376872549 | Jessica Lynn Watts | Licensed Practical Nurse | 117 E Main St, Hugo, OK 74743-6237 | 2009-12-16 |
| 1184766172 | Providence Service Corporation of Oklahoma | Case Management | 117 E Main St, Hugo, OK 74743-6237 | 2007-02-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053817775 | Emilia Sue Lopez | Registered Nurse | 2008 East 2110 Road, Hugo, OK 74743 | 2018-04-02 |
| 1144739657 | Healing Hearts Counseling & Consulting, L.L.C. | Clinic/Center | 1212 East Kirk, Hugo, OK 74743 | 2017-09-27 |
| 1457801177 | Kelli Lemke | Nurse Practitioner | 204 E. Jackson St., Hugo, OK 74743 | 2016-10-05 |
| 1780040147 | Shabreka Dorshell Coleman | Student in an Organized Health Care Education/Training Program | 1475 North 4220 Road, Grant, OK 74743 | 2016-01-14 |
| 1063898161 | Jaclyn Deann Rouse | Optometrist | 410 North M Street, Hugo, OK 74743 | 2015-07-31 |
| 1548519648 | Tori L Fowler | Counselor | 112 W. Jackson, Hugo, OK 74743 | 2012-09-05 |
| 1174802219 | Malinda Burnett | Counselor | 1100 David Roebuck Lane, Hugo, OK 74743 | 2011-08-08 |
| 1942591490 | Joshua Asher Tims | Clinic/Center | 1213 E. Jackson St, Hugo, OK 74743 | 2011-05-02 |
| 1598998320 | Kimberly Dawn Jones | Social Worker | 1717 1/2 West Jackson, Hugo, OK 74743 | 2009-08-27 |
| 1689812547 | Adeline Youngblood | Counselor | 612 E Jackson, Hugo, OK 74743 | 2009-01-30 |
| Find all providers in zip 74743 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942591490 | Joshua Asher Tims | Clinic/Center | 1213 E. Jackson St, Hugo, OK 74743 | 2011-05-02 |
| 1417011081 | Camelot Community Services of Oklahoma, LLC | Clinic/Center | 2816 E Jackson St, Suite C, Hugo, OK 74743-4250 | 2006-12-20 |
| 1003985896 | Southern Oklahoma Treatment Services, Inc. | Clinic/Center | 1213 East Jackson Street, Hugo, OK 74743 | 2006-11-07 |
| 1003243486 | Healing Hearts Counseling Center | Clinic/Center | 211 E Jackson St, Hugo, OK 74743-4036 | 2013-10-01 |
| 1164721056 | Providence Service Corp | Clinic/Center | 117 E Main St, Hugo, OK 74743-6237 | 2011-03-18 |
| 1639233703 | Sequelcare of Oklahoma, LLC | Clinic/Center | 2816 E Jackson St, Suite C, Hugo, OK 74743-4250 | 2006-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870742 | Sequelcare of Oklahoma, LLC | Clinic/Center | 6218 S Lewis Ave Ste 118, Tulsa, OK 74136-1018 | 2020-10-28 |
| 1649870890 | M & M Counseling Group, LLC | Clinic/Center | 207 S Czech Hall Rd, Yukon, OK 73099-6851 | 2020-10-27 |
| 1992303721 | Misty Watkins | Clinic/Center | 1601 Sw Parkridge Blvd Ste 200, Lawton, OK 73505-7564 | 2020-10-14 |
| 1295342046 | Integrative Healthcare Solutions LLC | Clinic/Center | 2227 E 8th St, Tulsa, OK 74104-3237 | 2020-09-25 |
| 1235744020 | Strength of A Warrior Counseling Services LLC | Clinic/Center | 4516 Se 25th St, Del City, OK 73115-4114 | 2020-09-09 |
| 1609488253 | Alexie Foster, LLC | Clinic/Center | 16802 S 301st West Ave, Bristow, OK 74010-2265 | 2020-08-17 |
| 1306455068 | Restore Family Counseling, LLC | Clinic/Center | 100 W. Wilshire, Suite #c3, Oklahoma City, OK 73116 | 2020-07-29 |
| 1245855857 | Dragonfly Psychotherapy | Clinic/Center | 2942 Ne Orlie Dr, Forest Park, OK 73121-2436 | 2020-06-09 |
| 1508480872 | Maria Nancy Martinez | Clinic/Center | 5350 S Western Ave Ste 217, Oklahoma City, OK 73109-4525 | 2020-06-03 |
| 1649894015 | Miranda Rackers | Clinic/Center | 1308 E Mckinley Ave, Sapulpa, OK 74066-4824 | 2020-06-02 |
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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.