Healthcare Provider Details
I. General information
NPI: 1427000843
Provider Name (Legal Business Name): PSYCHOTHERAPY & DIAGNOSTIC SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1818 W LINDSEY ST SUITE C-120
NORMAN OK
73069-4159
US
IV. Provider business mailing address
1818 W. LINDSEY ST SUITE C-120
NORMAN OK
73069-4169
US
V. Phone/Fax
- Phone: 405-366-8828
- Fax: 405-325-1478
- Phone: 405-366-8828
- Fax: 405-325-1478
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | 493 |
| License Number State | OK |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 115 |
| License Number State | OK |
VIII. Authorized Official
Name: DR.
MICHAEL
F.
DAVES
Title or Position: PARTNER
Credential: PH.D.
Phone: 405-366-8828