| Edwin Fair Community Mental Health Center, Inc. | |
|
1500 N 5th St Ponca City OK 74601-2758 | |
| (580) 762-7561 | |
| (580) 762-2576 |
| Full Name | Edwin Fair Community Mental Health Center, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1500 N 5th St, Ponca City, Oklahoma |
| Authorized Official Name and Position | Misty D Daniels (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5807627561 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edwin Fair Community Mental Health Center, Inc. 1500 N 5th St Ponca City OK 74601-2758 Ph: (580) 762-7561 | Edwin Fair Community Mental Health Center, Inc. 1500 N 5th St Ponca City OK 74601-2758 Ph: (580) 762-7561 |
| NPI Number | 1043382484 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 06/28/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043382484 | NPI | - | NPPES |
| 100749540D | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Grand Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 407 W South Ave, Ponca City, OK 74601 Phone: 580-308-5515 Fax: 580-749-5792 | |
Kara M. Smith, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 425 Fairview Ave, Suite 1, Ponca City, OK 74601 Phone: 580-382-5772 Fax: 580-382-5731 | |
Laura Peitz Counseling Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1912 Lake Rd, Ponca City, OK 74604 Phone: 580-762-6511 Fax: 580-762-6511 | |
Edwin Fair Community Mental Health Center Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 N 6th St, Ponca City, OK 74601 Phone: 580-762-7561 Fax: 580-762-2576 | |
Suzan B. Simmons, Ph.d,,pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1916 Lake Rd, Ponca City, OK 74604 Phone: 580-761-3799 | |
Jan Matheson Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1918 Lake Rd, Ponca City, OK 74604 Phone: 580-765-2581 |