Healthcare Provider Details

I. General information

NPI: 1679486898
Provider Name (Legal Business Name): BETHANY KAYE HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 S ASPEN AVE STE D
BROKEN ARROW OK
74012-7501
US

IV. Provider business mailing address

3512 E NASHVILLE ST
BROKEN ARROW OK
74014-2970
US

V. Phone/Fax

Practice location:
  • Phone: 918-940-7158
  • Fax: 918-512-2002
Mailing address:
  • Phone: 918-407-0342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: