Healthcare Provider Details

I. General information

NPI: 1194939629
Provider Name (Legal Business Name): AMY HUFFER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 11/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 NW EXPRESSWAY SUITE 700
OKLAHOMA CITY OK
73112-4493
US

IV. Provider business mailing address

3400 NW EXPRESSWAY SUITE 700
OKLAHOMA CITY OK
73112-4493
US

V. Phone/Fax

Practice location:
  • Phone: 405-949-3813
  • Fax: 405-951-8814
Mailing address:
  • Phone: 405-949-3813
  • Fax: 405-951-8814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3509
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3509
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: