Provider Demographics
NPI:1174742514
Name:MAYS, WILLIE JAMES JR (MA)
Entity type:Individual
Prefix:
First Name:WILLIE
Middle Name:JAMES
Last Name:MAYS
Suffix:JR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 829
Mailing Address - Street 2:
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73023-0829
Mailing Address - Country:US
Mailing Address - Phone:405-222-5437
Mailing Address - Fax:405-222-5441
Practice Address - Street 1:198 EAST ALMAR
Practice Address - Street 2:
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73023-0829
Practice Address - Country:US
Practice Address - Phone:405-222-5437
Practice Address - Fax:405-222-5441
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK3WJM65OtherICIS