Jim Taliaferro Cmhc

LBN: State Of Oklahoma
Jim Taliaferro Cmhc is an health care organization with primary practice located at 602 Sw 38Th Street , Lawton OK 73505-6912. The organization recently has 3 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Medical Specialty. Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. State Of Oklahoma can be contacted via phone (580) 248-5780, or through Lee, Terri via phone (580) 250-2640.

Contact Information

Primary practice address
602 Sw 38Th Street Lawton OK 73505-6912
Phone: (580) 248-5780
Fax: (580) 353-3202
Website:
Map and Directions
Authorized official contact:
Name: Lee, Terri Licensed Professional Counselor (LPC)
Phone: (580) 250-2640

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X 0005111 Oklahoma
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X 0005111 Oklahoma
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X

Profile Details

NPI number 1619012515
LBN Legal business name State Of Oklahoma
DBA Doing business as Jim Taliaferro Cmhc
Authorized official Lee, Terri Licensed Professional Counselor (LPC)
Entity Organization
Organization subpart 1 Yes
Enumeration date Feb 20th, 2007
Last updated Jan 30th, 2024 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619012515 NPPES
Oklahoma Other WCDLG MEDICARE PART B PROVIDER NUMBER
Oklahoma MEDICAID 100677270A MEDICARE PART B PROVIDER NUMBER
Oklahoma MEDICAID 100755860A MEDICARE PART B PROVIDER NUMBER
Oklahoma MEDICAID 100688870A MEDICARE PART B PROVIDER NUMBER

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