Healthcare Provider Details

I. General information

NPI: 1063399822
Provider Name (Legal Business Name): TELEPSYCH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 MCKOWN DR
NORMAN OK
73072-6678
US

IV. Provider business mailing address

11419 SPRINGHOLLOW RD APT 1005
OKLAHOMA CITY OK
73120-4636
US

V. Phone/Fax

Practice location:
  • Phone: 405-563-4511
  • Fax: 405-592-7978
Mailing address:
  • Phone: 214-436-2555
  • Fax: 405-592-7978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SEPIDEH AHMADPOUR
Title or Position: PROVIDER
Credential: APRN-PMHNP
Phone: 405-563-4511