Healthcare Provider Details

I. General information

NPI: 1508847682
Provider Name (Legal Business Name): RICHARD HARLEN SWINK PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RICHARD HARLEN SWINK PHD

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 E 19TH ST BLDG 103
EDMOND OK
73013-6627
US

IV. Provider business mailing address

1616 E 19TH ST BLDG 103
EDMOND OK
73013-6627
US

V. Phone/Fax

Practice location:
  • Phone: 405-341-3085
  • Fax: 405-341-0128
Mailing address:
  • Phone: 405-341-3085
  • Fax: 405-341-0128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number124
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number124
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: