Healthcare Provider Details

I. General information

NPI: 1225176472
Provider Name (Legal Business Name): NORMA JO BETHEL MHR,LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 ALAMEDA ST
NORMAN OK
73071-5229
US

IV. Provider business mailing address

1308 BEAUMONT ST
NORMAN OK
73071-2506
US

V. Phone/Fax

Practice location:
  • Phone: 405-573-3871
  • Fax: 405-573-3806
Mailing address:
  • Phone: 405-321-5399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC02202
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number2202
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: