Healthcare Provider Details

I. General information

NPI: 1205668928
Provider Name (Legal Business Name): ELLI FAITH BILLINGSLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 NW 14TH ST
OKLAHOMA CITY OK
73106-4450
US

IV. Provider business mailing address

1100 NW 14TH ST
OKLAHOMA CITY OK
73106-4450
US

V. Phone/Fax

Practice location:
  • Phone: 405-528-7211
  • Fax: 405-338-4743
Mailing address:
  • Phone: 405-528-7211
  • Fax: 405-338-4743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12350
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: