Healthcare Provider Details

I. General information

NPI: 1306850540
Provider Name (Legal Business Name): MARC LAWRENCE CHARNEY PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3516 NW 50TH ST
OKLAHOMA CITY OK
73112-5630
US

IV. Provider business mailing address

3516 NW 50TH ST
OKLAHOMA CITY OK
73112-5630
US

V. Phone/Fax

Practice location:
  • Phone: 405-943-7500
  • Fax: 405-943-7501
Mailing address:
  • Phone: 405-943-7500
  • Fax: 405-943-7501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number847
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number10
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: