MEDICARE: SCRIPTED MIND INC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1770386203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCRIPTED MIND INC

Provider Business Mailing Address
First Line	:	5840 S MEMORIAL DR STE 330
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74145-9060
Country	:	US
Telephone Number	:	918-200-9830
Fax Number	:	918-601-8103

Provider Business Practice Location Address
First Line	:	5840 S MEMORIAL DR STE 330
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74145-9060
Country	:	US
Telephone Number	:	918-200-9830
Fax Number	:	918-601-8103

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MR. DESMOND ERIC KETTER
Credential	:	LPC
Telephone Number	:	918-645-6064

Provider Enumeration Date	:	03/31/2025
Last Update Date	:	09/05/2025

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Directions to “SCRIPTED MIND INC ” Practice Location

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