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Mimi Kathryn Mohr

Social Worker

Behavioral Health & Social Service Providers

PECOS Enrollment

This provider is enrolled in PECOS as MIMI MOHR.

Based on the most recent information from CMS, provider Mimi Kathryn Mohr is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 11:47 AM.

Profile Details

Provider ID
1285971218
Provider Type
Individual
Full Name
Mohr, Mimi Kathryn
Title
Ms.
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
1/10/2013
Last Updated
3/16/2022

Contact Information

Practice Location

6655 S Yale Ave, Tulsa, OK 74136-3326

(918) 491-3700

(918) 481-4063

Mailing Location

PO Box 707001, Tulsa, OK 74170-7001

(888) 247-0125

(918) 502-0881

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 5365 Oklahoma

Provider Identifiers

ID	Description	Issuer
ID 200507120A	Description Medicaid	Issuer Unlisted Oklahoma

Mimi Kathryn Mohr

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Broam, Ezrikai

Kluemper, Jacqueline L

Dorsey, Donna Deneen

Jukich, David

Miller, Susan

Ragsdale, Chandler

Kimbrough, Ebony

Burnshire, Julie Marie

Palmer, Dustin Alan

Moody, Ramona S