MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA (NPI# 1588700793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588700793 |
| Entity Type | Organization |
| Organization Name | MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA |
| Practice Address |
2530 S Commerce Bldg A Ardmore OK 73401 |
| Mailing Address |
Po Box 189 Ardmore OK 73402-0189 |
| Practice Telephone | 5802235070 |
| Practice Fax Number | 5802235617 |
| Mailing Telephone | 5802235070 |
| Mailing Fax Number | 5802235617 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DEBRA WOODBRIDGE (IS COORDINATOR) |
| Authorized Official Telephone | 5802235070 |
| Authorized Official Credential | CPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235394792 | Mental Health Services of Southern Oklahoma | Case Management | 93 Broadlawn Village, Ardmore, OK 73401-1722 | 2008-07-24 |
| 1922266964 | Mental Health Services of Southern Oklahoma | Community/Behavioral Health | #2 Broadlawn, Ardmore, OK 73402-1722 | 2008-05-27 |
| 1144404252 | Mental Health Services of Southern Oklahoma | Clinic/Center | 91 Broadlawn, Ardmore, OK 73401 | 2007-12-26 |
| 1780867812 | Mental Health Services of Southern Oklahoma | Clinic/Center | 209 E Wilson St, Tishomingo, OK 73460-2200 | 2007-12-12 |
| 1760528970 | Mental Health Services of Southern Oklahoma | Case Management | 200 Wanda St, Marietta, OK 73448 | 2007-01-29 |
| 1710023924 | Mental Health Services of Southern Oklahoma | Clinic/Center | 93 Broadlawn, Ardmore, OK 73401-6337 | 2007-01-29 |
| 1992841100 | Mental Health Services of Southern Oklahoma | Case Management | 111 E 12th St, Ada, OK 74820-6501 | 2007-01-29 |
| 1972659910 | Mental Health Services of Southern Oklahoma | Clinic/Center | 603 S 1st St, Madill, OK 73446-3807 | 2007-01-25 |
| 1831245885 | Mental Health Services of Southern Oklahoma | Clinic/Center | 414 W Muskogee Ave, Sulphur, OK 73086-4614 | 2007-01-25 |
| 1518997097 | Mental Health Services of Southern Oklahoma | Community/Behavioral Health | 2530 S. Commerce, Building A, Ardmore, OK 73401-5519 | 2006-07-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA | 1012 14th Ave Nw, Ardmore, OK 73401-5734 |
| Oklahoma Business Registrations | MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA | Po Box 189, Ardmore, OK 73402 |
| Oklahoma Business Registrations | MENTAL HEALTH SERVICES OF SOUTHERN OKLAHOMA, INC. |
| Street Address |
2530 S COMMERCE BLDG A |
| City | ARDMORE |
| State | OK |
| Zip Code | 73401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912053612 | Lighthouse Behavioral Wellness Centers | Clinic/Center | 2530 S Commerce, Bldg B, Ardmore, OK 73401 | 2007-01-26 |
| 1497914428 | Katheryn Darlene James | Case Manager/Care Coordinator | 2530 S Commerce, Ardmore, OK 73401-0189 | 2008-06-05 |
| 1699966093 | Carol M Stuart | Counselor | 2530 S Commerce, Ardmore, OK 73401 | 2007-08-09 |
| 1619168853 | Evelyn Southers | Case Manager/Care Coordinator | 2530 S Commerce, Ardmore, OK 73401-0189 | 2007-08-05 |
| 1881884807 | Lighthouse Behavioral Wellness Centers | Clinic/Center | 2530 S Commerce, Bldg A, Ardmore, OK 73401-0189 | 2007-07-26 |
| 1124225917 | Stephanie Leanne Jefferson | Counselor | 2530 S Commerce, Ardmore, OK 73401 | 2007-06-27 |
| 1760689574 | Avis M Taylor | Counselor | 2530 S Commerce, Ardmore, OK 73401 | 2007-06-27 |
| 1477759744 | Sherry White | Counselor | 2530 S Commerce, Ardmore, OK 73401 | 2007-06-25 |
| 1457556664 | Michelle Denise Austin | Case Manager/Care Coordinator | 2530 S Commerce, Ardmore, OK 73401 | 2007-06-18 |
| 1639373954 | Lisa Nichole Todd | Counselor | 2530 S Commerce, Ardmore, OK 73401-0189 | 2007-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497391452 | Abbie Deeann Mclemore | Nurse Practitioner | 915 10th Ave, Ardmore, OK 73401 | 2019-11-25 |
| 1790349991 | Shirley Denise Brown | Licensed Psychiatric Technician | 1219 Kst N.w, 1219 Kst N.w, Ardmore, OK 73401 | 2019-04-24 |
| 1427512359 | Billy Joe Oshields | Case Manager/Care Coordinator | 6862 State Hwy 199 Ardmore Oklahoma, 6862 State Hwy 199, Ardmore, OK 73401 | 2019-01-24 |
| 1174007595 | Tawnya Dawn Peery | Nurse Practitioner | 1108 W. Walnut Drive, Ardmore, OK 73401 | 2018-09-21 |
| 1679055016 | Teresa Marie Hernandez | Behavior Technician | 1219 K St. Nw, Ardmore, OK 73401 | 2018-09-01 |
| 1063991974 | Sawyer Rae Shamburger | Occupational Therapy Assistant | 208 North Praire St, Pilot Point, TX 73401 | 2018-08-10 |
| 1417473521 | Chelsye Bacon | Peer Specialist | 905 Holiday Drive, Ardmore, OK 73401 | 2017-08-21 |
| 1003279746 | Jeni Presley | Marriage & Family Therapist | Outpatient Services-ardmore; 2510 Chickasaw Dr., Strong Family Development;, Ardmore, OK 73401 | 2016-03-31 |
| 1982080909 | Alison Hill | Pharmacist | 1111 N. Commerce, Ardmore, OK 73401 | 2015-07-31 |
| 1316346547 | Olivia Larae Carrell | Counselor | 15 Monroe Street Ne, Ardmore, OK 73401 | 2014-08-13 |
| Find all providers in zip 73401 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770913568 | Michael Thomas | Psychologist | 830 Cricket Ave, Apt B, Ardmore, PA 19003-2035 | 2013-11-15 |
| 1326161399 | Timothy Patrick Foley | Psychologist | 819 Lorraine Ave, Ardmore, PA 19003-3017 | 2007-04-06 |
| 1225156508 | James Michael Gould | Psychologist | 2743 Morris Rd, Ardmore, PA 19003-1909 | 2007-03-26 |
| 1265808554 | Jacqueline Duci | Psychologist | 133 Coulter Ave, Ardmore, PA 19003-2416 | 2015-08-20 |
| 1922268671 | Richard Jay Reisboard | Psychologist | 119 Coulter Ave, Suite 101, Ardmore, PA 19003-2427 | 2008-06-16 |
| 1831394600 | Susan Leigh Metrick | Psychologist | 125 Coulter Ave, Ardmore, PA 19003-2410 | 2007-06-20 |
| 1952519597 | Sue Riddle Carey | Psychologist | 105 Sibley Ave, Ardmore, PA 19003-2311 | 2007-05-18 |
| 1871710301 | Elizabeth R. Richman | Psychologist | 133 Coulter Ave, Suite 1, Ardmore, PA 19003 | 2007-04-19 |
| 1689897613 | Karen Berberian, L.L.C. | Psychologist | 233 E Lancaster Ave, Suite 303a, Ardmore, PA 19003-2321 | 2007-04-10 |
| 1740343409 | Stephen Martin | Psychologist | 119 Coulter Ave, Ardmore, PA 19003-2427 | 2006-12-17 |
| Find all providers in ARDMORE | ||||
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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.