Healthcare Provider Details

I. General information

NPI: 1720934656
Provider Name (Legal Business Name): INFINITE GROWTH PERFORMANCE PSYCHOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 N MOORE AVE STE 18
MOORE OK
73160-3612
US

IV. Provider business mailing address

4928 S BRIARWOOD DR
OKLAHOMA CITY OK
73135-1202
US

V. Phone/Fax

Practice location:
  • Phone: 405-633-0316
  • Fax:
Mailing address:
  • Phone: 405-633-0316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: WES WARNER
Title or Position: PARTNER
Credential: LPC
Phone: 405-200-3600