Healthcare Provider Details

I. General information

NPI: 1548895931
Provider Name (Legal Business Name): COURT ASSISTANCE PROGRAMS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2020
Last Update Date: 03/06/2020
Certification Date: 03/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N DEWEY AVENUE SUITE 100
OKLAHOMA CITY OK
73102
US

IV. Provider business mailing address

600 N DEWEY AVENUE SUITE 100
OKLAHOMA CITY OK
73102
US

V. Phone/Fax

Practice location:
  • Phone: 405-290-7322
  • Fax: 405-290-7325
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY JEAN WICKSTROM
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 405-290-7322