Provider Demographics
NPI:1003826652
Name:MMLD INC
Entity Type:Organization
Organization Name:MMLD INC
Other - Org Name:NEW BEGINNINGS COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXEC DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BURTON-PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-601-2307
Mailing Address - Street 1:1330 N CLASSEN
Mailing Address - Street 2:STE 314
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-6834
Mailing Address - Country:US
Mailing Address - Phone:405-601-2307
Mailing Address - Fax:405-601-3317
Practice Address - Street 1:1330 N CLASSEN
Practice Address - Street 2:STE 314
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-6834
Practice Address - Country:US
Practice Address - Phone:405-601-2307
Practice Address - Fax:405-601-3317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK2000077440AMedicaid