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MIRAGE IANA EMANNI MACK
NPI 1558031302
Case Manager/Care Coordinator in Tulsa, OK

Active since September 14, 2021
6333 E SKELLY DR, TULSA, OK 74135(918) 664-4224(918) 663-0203 Get Directions Write a Review

NPPES record last updated: October 19, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 19, 2022, Sep 14, 2021 (2 updates tracked since 2021).

About Mirage Iana Emanni Mack NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIRAGE IANA EMANNI MACK (NPI 1558031302) is an individual case manager/care coordinator provider in Tulsa, Oklahoma and active in the NPI registry since September 2021.

NPPES Registry Identity

NPI1558031302
Entity TypeIndividualFemale
Primary Taxonomy171M00000X
Provider Legal NameMIRAGE IANA EMANNI MACK
Location Address6333 E SKELLY DRTulsa, OK 74135-6106
Mailing Address6333 E Skelly DrTulsa, OK 74135-6106 · (918) 664-4224 · Fax (918) 663-0203
Phone(918) 664-4224
Fax(918) 663-0203
Sole ProprietorNo
Enumeration DateSeptember 14, 2021
Last NPPES UpdateOctober 19, 20222 updates tracked since enumeration
NPPES CertifiedOctober 19, 2022
✔ NPI 1558031302 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers
Taxonomy Code171M00000X
Definition
A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.
6333 E SKELLY DR, Tulsa, OK 74135
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JERRY LEE MANUS
Case Manager/Care Coordinator
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (918) 664-4224
KRYSTAL DAWN HUTCHINSON
Peer Specialist
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (918) 779-7216
MS. ABIGAIL ELIZABETH CARLISLE
Case Manager/Care Coordinator
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (000) 000-0000
TANYA CRAWFORD RN
Registered Nurse
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (918) 664-4224
KELLI ANN ORDORICA
Case Manager/Care Coordinator
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (918) 779-7151
JAYSON SWISHER
Peer Specialist
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (918) 664-4224
IVAN HONEYCUTT
Peer Specialist
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (918) 222-2222
GLORY S KALAKURCHA M.A.
Counselor (Addiction (Substance Use Disorder))
6333 E SKELLY DR
TULSA, OK 74135
Tulsa County (918) 664-4224

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mirage Mack's NPI number?

The NPI number for Mirage Mack is 1558031302. It was assigned to this individual provider in the NPPES registry on September 14, 2021.

Where is Mirage Mack located?

Mirage Mack practices at 6333 E Skelly Dr, Tulsa, OK 74135. The listed phone number is (918) 664-4224.

What is Mirage Mack's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

When was this NPI record last updated?

The NPPES record for Mirage Mack was last updated on October 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.