Healthcare Provider Details

I. General information

NPI: 1679278584
Provider Name (Legal Business Name): NORTH OKLAHOMA COUNTY MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 W 15TH ST
EDMOND OK
73013-3621
US

IV. Provider business mailing address

PO BOX 12978
OKLAHOMA CITY OK
73157-2978
US

V. Phone/Fax

Practice location:
  • Phone: 405-858-2700
  • Fax:
Mailing address:
  • Phone: 405-858-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LONNIE RICE
Title or Position: CFO
Credential:
Phone: 405-858-2735