| Ok Psych Np Llc | |
|
1509 Nw 198th St Edmond OK 73012-3465 | |
| (918) 810-9118 | |
| Not Available |
| Full Name | Ok Psych Np Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1509 Nw 198th St, Edmond, Oklahoma |
| Authorized Official Name and Position | Ashley Mathias (PMHNP) |
| Authorized Official Contact | 9188109118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ok Psych Np Llc 1509 Nw 198th St Edmond OK 73012-3465 Ph: () - | Ok Psych Np Llc 1509 Nw 198th St Edmond OK 73012-3465 Ph: (918) 810-9118 |
| NPI Number | 1972281574 |
|---|---|
| Provider Enumeration Date | 07/05/2023 |
| Last Update Date | 08/17/2023 |
| Certification Date | 08/17/2023 |
| Medicare PECOS PAC ID | 9739543174 |
|---|---|
| Medicare Enrollment ID | O20230918003467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972281574 | NPI | - | NPPES |
| 2084P0805X | Medicaid | OK | |
| 2084P0800X | Medicaid | OK | |
| 2084P0804X | Medicaid | OK | |
| 2084H0002X | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Ashley Mathias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326588526 PECOS PAC ID: 5294012928 Enrollment ID: I20170508001066 |
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