PROVIDENCE SERVICE CORPORATION OF OKLAHOMA (NPI# 1740340157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740340157 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE SERVICE CORPORATION OF OKLAHOMA |
| Other Organization Name | PROVIDENCE OF OKLAHOMA |
| Practice Address |
105 Plaza Madill OK 73446-2248 |
| Mailing Address |
620 N Craycroft Rd Tucson AZ 85711-1448 |
| Practice Telephone | 5807957439 |
| Practice Fax Number | 5807957444 |
| 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 |
|---|---|---|---|---|
| 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 |
| 1184766172 | Providence Service Corporation of Oklahoma | Case Management | 117 E Main St, Hugo, OK 74743-6237 | 2007-02-13 |
| Street Address |
105 PLAZA |
| City | MADILL |
| State | OK |
| Zip Code | 73446-2248 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659715134 | Bryan Rowley | Counselor | 105 Plaza, Madill, OK 73446-2248 | 2013-04-26 |
| 1295016376 | Victoria Ellen Marshall | Counselor | 105 Plaza, Madill, OK 73446-2248 | 2011-09-02 |
| 1720371586 | Carol J Brown | Psychologist | 105 Plaza, Madill, OK 73446-2248 | 2011-05-25 |
| 1306139258 | Heather M Farmer | Counselor | 105 Plaza, Madill, OK 73446-2248 | 2011-05-25 |
| 1154613917 | Michael Crutchfield | Counselor | 105 Plaza, Madill, OK 73446 | 2011-05-11 |
| 1831411263 | Johnny Duane Green | Counselor | 105 Plaza, Madill, OK 73446-2248 | 2010-02-26 |
| 1073835450 | Kaylyn Dawn Weldon Gary | Counselor | 105 Plaza, Madill, OK 73446-2248 | 2010-02-25 |
| 1033431564 | Danah Renae Martin | Counselor | 105 Plaza, Madill, OK 73446-2248 | 2010-02-25 |
| 1598087140 | Victoria Lynn Pacheco | Counselor | 105 Plaza, Madill, OK 73446-2248 | 2010-02-24 |
| 1164627287 | Melanie Gayle Gann | Counselor | 105 Plaza, Madill, OK 73446 | 2007-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104306943 | Jennifer Duncan | Case Manager/Care Coordinator | 605 S. 1st, Madill, OK 73446 | 2018-08-21 |
| 1710228853 | Southeastern Oklahoma Family Services, Inc. | Community/Behavioral Health | 605 1st Street, Madill, OK 73446 | 2013-03-14 |
| 1285975581 | Madill Dental Company | Dentist | 804 S 1st St Suite C, Madill, OK 73446 | 2013-03-12 |
| 1174812879 | Lori Ann Black | Counselor | 109 South 1st, Madill, OK 73446 | 2011-04-04 |
| 1598090318 | Marshall County Ems District | Ambulance | Four Hospital Drive, Madill, OK 73446 | 2009-10-13 |
| 1598969800 | Tanya L Magness | Counselor | 300 E Wolf St, Madill, OK 73446 | 2007-06-12 |
| 1629100524 | Stacy James Rendon | Occupational Therapy Assistant | 210 Brookside Drive, Madill, OK 73446 | 2007-03-09 |
| 1194881367 | Carren D Tshirlig | Occupational Therapist | Hwy 99 S, Madill, OK 73446 | 2006-12-29 |
| 1912000886 | Courtney Thomas | Physical Therapy Assistant | 310 Brookside Dr., Madill, OK 73446 | 2006-09-06 |
| 1700993797 | Wapiti Orthopedics PC | Orthopaedic Surgery | #1 Hospital Drive, Madill, OK 73446 | 2006-08-24 |
| Find all providers in zip 73446 | ||||
| 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 |
|---|---|---|---|---|
| 1972659910 | Mental Health Services of Southern Oklahoma | Clinic/Center | 603 S 1st St, Madill, OK 73446-3807 | 2007-01-25 |
| 1669866547 | Yco Tulsa, Inc. | Clinic/Center | 605 S 1st St, Suite A, Madill, OK 73446-3807 | 2015-03-27 |
| 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.