MEDICARE: AUDREY LENTZ

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	101YM0800X	Mental Health Counselor	11583	OK

General Provider Information

NPI Number	:	1831894187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUDREY LENTZ

Provider Business Mailing Address
First Line	:	12220 N MACARTHUR BLVD STE F18
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-1850
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12220 N MACARTHUR BLVD STE F18
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-1850
Country	:	US
Telephone Number	:	832-330-6506
Fax Number	:

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

Provider Enumeration Date	:	04/04/2023
Last Update Date	:	06/22/2025

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Directions to “ AUDREY LENTZ ” Practice Location

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