Healthcare Provider Details

I. General information

NPI: 1245159292
Provider Name (Legal Business Name): MARY SARGEANT COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1733 W 33RD ST STE 110
EDMOND OK
73013-3866
US

IV. Provider business mailing address

1733 W 33RD ST STE 110
EDMOND OK
73013-3866
US

V. Phone/Fax

Practice location:
  • Phone: 405-441-3578
  • Fax:
Mailing address:
  • Phone: 405-441-3478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARY SARGEANT
Title or Position: THERAPIST
Credential:
Phone: 405-441-3578