Healthcare Provider Details

I. General information

NPI: 1528749447
Provider Name (Legal Business Name): ADAMS PSYCHOLOGICAL ASSESSMENT AND THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2023
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17935 N PENNSYLVANIA AVE STE 201
EDMOND OK
73012-9288
US

IV. Provider business mailing address

1687 WELLINGTON RD
NEWCASTLE OK
73065-2302
US

V. Phone/Fax

Practice location:
  • Phone: 405-285-2110
  • Fax:
Mailing address:
  • Phone: 405-574-2836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name: LAUREN ADAMS
Title or Position: HEALTH SERVICE PSYCHOLOGIST
Credential: PHD
Phone: 405-574-2836