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PINE RIDGE MENTAL HEALTHCARE LLC NPI 1346828050


NPI Information

NPI: 1346828050
Provider Name: PINE RIDGE MENTAL HEALTHCARE, LLC
Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

CLIA Number: 37D2274214

Address:
8422 N 123RD EAST AVE
OWASSO, OK
ZIP 74055
Phone: (918) 858-4353
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PINE RIDGE MENTAL HEALTHCARE, LLC is a psychiatry psychiatry neurology in Owasso, OK. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. PINE RIDGE MENTAL HEALTHCARE, LLC NPI is 1346828050. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

8422 N 123RD EAST AVE
OWASSO, OK
ZIP 74055-130
Phone: (918) 858-4353

The provider's authorized official is Nicole Mason .
The authorized official title is Owner and has the following contact phone number (618) 781-8686.

The CLIA number assigned to this NPI record is 37D2274214 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/1/2021 and was last updated on 12/2/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthNo
2103TC0700XPsychologistClinicalNo
3163WP0808XRegistered NursePsychiatric/Mental HealthNo
4164W00000XLicensed Practical NurseNo
5207Q00000XFamily MedicineNo
6363A00000XPhysician AssistantNo
7376K00000XNurse's AideNo
82084P0800XPsychiatry & NeurologyPsychiatryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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