Healthcare Provider Details

I. General information

NPI: 1972910982
Provider Name (Legal Business Name): CHUKWUDI OPARAKU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 GREENBRIAR PL
OKLAHOMA CITY OK
73159-7640
US

IV. Provider business mailing address

1609 GREENBRIAR PL
OKLAHOMA CITY OK
73159-7640
US

V. Phone/Fax

Practice location:
  • Phone: 405-424-7711
  • Fax: 405-735-3524
Mailing address:
  • Phone: 405-735-3683
  • Fax: 405-735-3524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number88821
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: