Healthcare Provider Details

I. General information

NPI: 1629341342
Provider Name (Legal Business Name): CREOKS MENTAL HEALTH SEERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2012
Last Update Date: 10/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S DEWEY AVE STE 108
BARTLESVILLE OK
74003-3525
US

IV. Provider business mailing address

4301 SOUTH YALE AVE, STE B
TULSA OK
74135
US

V. Phone/Fax

Practice location:
  • Phone: 918-336-0810
  • Fax: 918-336-0836
Mailing address:
  • Phone: 918-382-7300
  • Fax: 918-382-7302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberCMHC-561
License Number StateOK

VIII. Authorized Official

Name: MRS. BRANDI SMITH
Title or Position: CLINICAL DIRECTOR
Credential: LPC
Phone: 918-382-7300