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PROVIDENCE OF OKLAHOMA
NPI 1639239023
Clinic/Center - Mental Health (Including Community Mental Health Center) in Antlers, OK

Active since December 08, 2006
301 N HIGH ST, ANTLERS, OK 74523(580) 298-5779(580) 298-5016 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Providence Of Oklahoma NPPES

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

PROVIDENCE OF OKLAHOMA (NPI 1639239023) is a healthcare organization registered as a mental health (including community mental health center) in Antlers, Oklahoma and active in the NPI registry since December 2006. The organization lists Breeann Marie Hoerning, Ar And Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1639239023
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NamePROVIDENCE SERVICE CORPORATION OF OKLAHOMA
Location Address301 N HIGH STAntlers, OK 74523-2238
Mailing Address620 N Craycroft RdTucson, AZ 85711-1448 · (520) 747-6600 · Fax (520) 747-6613
Phone(580) 298-5779
Fax(580) 298-5016
Organization SubpartNo
Authorized OfficialBreeann Marie HoerningAr And Billing Manager · (520) 747-6600
Enumeration DateDecember 8, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1639239023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
301 N HIGH ST, Antlers, OK 74523
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Other Names 1

Doing Business AsProvidence Of Oklahoma

Other Identifiers 1

Medicaid100750190MOK

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.

MRS. STACEY COLETTE FRANKS MBS,LBP
Counselor (Mental Health)
301 N HIGH ST
ANTLERS, OK 74523
Pushmataha County (580) 298-5779
MS. JENNIFER ANNE GORDON BA, PSRS, CM II
Counselor
301 N HIGH ST
ANTLERS, OK 74523
Pushmataha County (580) 372-3645
MR. FRANKIE JOE COUCH JR. MBS
Counselor
301 N HIGH ST
ANTLERS, OK 74523
Pushmataha County (580) 298-5779
SARA MICHELLE BARNETT BA, MED, PSRS
Behavior Analyst
301 N HIGH ST
ANTLERS, OK 74523
Pushmataha County (580) 298-5779
MS. JENNIFER ANNE HAIRRELL B.A., REHAB SPEC
Counselor (Mental Health)
301 N HIGH ST
ANTLERS, OK 74523
Pushmataha County (580) 298-5779
MRS. AINSLEY JALAYNE WATTS
Case Management
301 N HIGH ST
ANTLERS, OK 74523
Pushmataha County (580) 271-1638
MS. MELISSA DAWN CLEM BA PSYCHOLOGY
Case Manager/Care Coordinator
301 N HIGH ST
ANTLERS, OK 74523
Pushmataha County (580) 271-7055
MRS. TRACY ANN BAILEY
Case Manager/Care Coordinator
301 N HIGH ST
ANTLERS, OK 74523
Pushmataha County (580) 298-7055

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 Providence Service Corporation Of Oklahoma's NPI number?

The NPI number for Providence Service Corporation Of Oklahoma is 1639239023. It was assigned to this organization in the NPPES registry on December 8, 2006. The provider is doing business as Providence Of Oklahoma.

Where is Providence Service Corporation Of Oklahoma located?

Providence Service Corporation Of Oklahoma is located at 301 N High St, Antlers, OK 74523. The listed phone number is (580) 298-5779.

What is Providence Service Corporation Of Oklahoma's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Providence Service Corporation Of Oklahoma was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.