Healthcare Provider Details

I. General information

NPI: 1205178209
Provider Name (Legal Business Name): MELISSA SUE UPTON MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2013
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8125 S WALKER AVE
OKLAHOMA CITY OK
73139-9417
US

IV. Provider business mailing address

8125 S WALKER AVE
OKLAHOMA CITY OK
73139-9417
US

V. Phone/Fax

Practice location:
  • Phone: 405-634-4400
  • Fax:
Mailing address:
  • Phone: 405-634-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: