Healthcare Provider Details

I. General information

NPI: 1639010630
Provider Name (Legal Business Name): AUTUMN HORIZONS THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9209 N WESTERN AVE
OKLAHOMA CITY OK
73114-2623
US

IV. Provider business mailing address

9209 N WESTERN AVE
OKLAHOMA CITY OK
73114-2623
US

V. Phone/Fax

Practice location:
  • Phone: 405-374-5178
  • Fax:
Mailing address:
  • Phone: 405-374-5178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CLAIRE NASH
Title or Position: CEO
Credential: LPC
Phone: 405-374-5178