Pine Ridge Mental Healthcare, LLC
Psychiatry & Neurology, Psychiatry in Owasso, OK. Organization (NPI-2).
NPI number1346828050
StatusActive
Last updated in NPPESOct 10, 2026
Details
- NPI
- 1346828050
- Entity type
- Organization (NPI-2)
- Legal business name
- Pine Ridge Mental Healthcare, LLC
- Organization subpart
- No
- Enumeration date
- Apr 1, 2021
- Certification date
- Oct 10, 2026
- Last updated
- Oct 10, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | – | – | |
| 103TC0700X | Psychologist, Clinical | – | – | |
| 163WP0808X | Registered Nurse, Psych/Mental Health | – | – | |
| 164W00000X | Licensed Practical Nurse | – | – | |
| 207Q00000X | Family Medicine | – | – | |
| 363A00000X | Physician Assistant | – | – | |
| 376K00000X | Nurse's Aide | – | – |
Practice location
8418 N 123rd East AveOwasso, OK 74055-2139
Phone 918-858-4353
Mailing address
8418 N 123rd East AveOwasso, OK 74055-2139
Phone 918-858-4353 · Fax 866-246-2942
Other practice locations
329 S Elm St Ste 240
Jenks, OK 74037-3765
Jenks, OK 74037-3765
Phone 918-858-4353 · Fax 866-246-2942
1100 W Blue Starr Dr
Claremore, OK 74017-2638
Claremore, OK 74017-2638
Phone 918-858-4353 · Fax 866-246-2942
Authorized official
Nicole Mason
Owner
6187818686
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.