MODOC NATION (NPI# 1821636358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821636358 |
| Entity Type | Organization |
| Organization Name | MODOC NATION |
| Other Organization Name | MODOC YOUTH AND FAMILY SERVICES |
| Practice Address |
615 H St Se Miami OK 74354-7908 |
| Mailing Address |
22 N Eight Tribes Trl Miami OK 74354-1011 |
| Practice Telephone | 9184189756 |
| Mailing Telephone | 9184189756 |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2020-08-17 |
| Authorized Official Name | JESSICA MULLIN (MYFS DIRECTOR) |
| Authorized Official Telephone | 9184189756 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | SKOK0 | 05 |
| Other Name | Type Code |
|---|---|
| Modoc Youth and Family Services | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | MODOC NATION | 435 N 6th St, Klamath Falls, OR 97601 |
| Street Address |
615 H ST SE |
| City | MIAMI |
| State | OK |
| Zip Code | 74354-7908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073913950 | Jessica Mullin | Counselor | 615 H St Se, Miami, OK 74354-7908 | 2014-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447786603 | Coal Creek Counseling, LLC | Social Worker | 204 D St Ne, Miami, OK 74354 | 2017-05-10 |
| 1164958567 | Yco Tulsa, Inc | Counselor | 1458 E Steve Owens Blvd, Miami, OK 74354 | 2017-05-04 |
| 1982064226 | Yco Tulsa, Inc | Clinic/Center | 1519 E Steve Owens Blvd, Miami, OK 74354 | 2016-02-29 |
| 1548641285 | Courtney Marie Winfrey | Occupational Therapy Assistant | 310 2nd Ave Sw Fl 3, Miami, OK 74354 | 2015-06-17 |
| 1417338039 | Michelle Dawn Johnson | Case Manager/Care Coordinator | 1519 E. Steve Owens Blvd, Miami, OK 74354 | 2015-06-10 |
| 1790100337 | Jordan Taylor-threet | Speech-Language Pathologist | 2225 N. Main St., Miami, OK 74354 | 2014-02-19 |
| 1700137551 | Miami Healthcare, LLC | Skilled Nursing Facility | 2530 North Elm St., Miami, OK 74354 | 2012-09-19 |
| 1144507534 | Julia Brown | Pharmacist | 11 West Central, Miami, OK 74354 | 2011-11-14 |
| 1841504685 | Dodie A Giles Keith | Counselor | 33 C Street Northeast, Miami, OK 74354 | 2010-08-04 |
| 1013221571 | Katherine Renee Burke | Counselor | 111 S. Treaty Rd., Miami, OK 74354 | 2010-07-27 |
| Find all providers in zip 74354 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750942074 | Current Intervention Family Therapy Services | Clinic/Center | 2223 N Main St, Miami, OK 74354-1620 | 2019-06-26 |
| 1942769567 | Veronica Castro, Psy.d., Pa | Clinic/Center | 9380 Sunset Dr Ste B165, Miami, FL 33173-5456 | 2019-03-13 |
| 1821659186 | Counselor Care | Clinic/Center | 5201 Blue Lagoon Dr # 891, Miami, FL 33126-2064 | 2019-06-26 |
| 1336504828 | Magalis Aguilera, Psy.d., P.a | Clinic/Center | 9240 Sw 72nd St, Suite 106, Miami, FL 33173-3261 | 2015-12-28 |
| 1699097782 | Paica A Psychological Assessment and Intervention for Children | Clinic/Center | 8080 W Flagler St, Suite 3c, Miami, FL 33144-2100 | 2010-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508499401 | Julia Jones, Lpc, Pllc | Clinic/Center | 2000 E 15th St Ste 400, Edmond, OK 73013-6697 | 2020-02-19 |
| 1285273920 | Psychiatric Wellness Aprn-cnp Pllc | Clinic/Center | 600 W Boeing Dr Ste D, Midwest City, OK 73110-3035 | 2019-12-28 |
| 1609431790 | New View Therapy | Clinic/Center | 3113 24th Ave Se, Norman, OK 73071-1742 | 2019-05-05 |
| 1932665841 | Flow Counseling Services | Clinic/Center | 6130 E 32nd St Ste 104, Tulsa, OK 74135-5454 | 2019-02-15 |
| 1427551860 | Bold Hearts and Sound Minds LLC | Clinic/Center | 1601 S State St Ste 375, Edmond, OK 73013-3626 | 2018-03-12 |
| 1427557891 | G Parks Phd Pllc | Clinic/Center | 6608 N Western Ave # 453, Oklahoma City, OK 73116-7326 | 2018-02-12 |
| 1578061578 | Life Mind, Pllc | Clinic/Center | 2624 E 22nd Pl, Tulsa, OK 74114-3131 | 2018-01-25 |
| 1144739657 | Healing Hearts Counseling & Consulting, L.L.C. | Clinic/Center | 1212 East Kirk, Hugo, OK 74743 | 2017-09-27 |
| 1851800825 | Seyva LLC | Clinic/Center | 8522 S 70th E Ave, Tulsa, OK 74133 | 2017-09-21 |
| 1386169969 | Big Love Counseling and Wellness | Clinic/Center | 1210 Roosevelt St Ste 220, Edmond, OK 73034-5176 | 2017-08-04 |
| Find all providers with the same taxonomy | ||||
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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.