Healthcare Provider Details

I. General information

NPI: 1700798592
Provider Name (Legal Business Name): LAUREN CHANCEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 S DOUGLAS BLVD STE E
MIDWEST CITY OK
73130-5265
US

IV. Provider business mailing address

2824 NW 45TH ST
OKLAHOMA CITY OK
73112-8222
US

V. Phone/Fax

Practice location:
  • Phone: 877-637-2614
  • Fax:
Mailing address:
  • Phone: 405-255-6845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: