Healthcare Provider Details

I. General information

NPI: 1962628347
Provider Name (Legal Business Name): JOSEPH GARRISON III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 12/14/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1923 S. DIVISION
GUTHRIE OK
73044
US

IV. Provider business mailing address

1222 10TH ST STE 211
WOODWARD OK
73801-3156
US

V. Phone/Fax

Practice location:
  • Phone: 405-282-1830
  • Fax: 405-282-1861
Mailing address:
  • Phone: 405-282-1830
  • Fax: 405-282-1861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC 2022
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: