Healthcare Provider Details

I. General information

NPI: 1184901720
Provider Name (Legal Business Name): KARA M ANADY PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2011
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2524 N BROADWAY # 480
EDMOND OK
73034-4172
US

IV. Provider business mailing address

1305 DEVONSHIRE CT
EDMOND OK
73034-5784
US

V. Phone/Fax

Practice location:
  • Phone: 405-856-6965
  • Fax:
Mailing address:
  • Phone: 847-293-8749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1304
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number1304
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number458
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: