MEDICARE: MARIE VAN PATTEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	6230	OK

General Provider Information

NPI Number	:	1295146520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE VAN PATTEN

Provider Business Mailing Address
First Line	:	5555 S LEWIS AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-7104
Country	:	US
Telephone Number	:	918-779-4556
Fax Number	:	918-895-6917

Provider Business Practice Location Address
First Line	:	5555 S LEWIS AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-7104
Country	:	US
Telephone Number	:	918-779-4556
Fax Number	:	918-895-6917

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2014
Last Update Date	:	03/09/2026

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Directions to “ MARIE VAN PATTEN ” Practice Location

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