Healthcare Provider Details

I. General information

NPI: 1821205022
Provider Name (Legal Business Name): WENONA RAY BARNES PH.D, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 NW 64TH ST SUITE 501
OKLAHOMA CITY OK
73116-1684
US

IV. Provider business mailing address

4045 NW 64TH ST SUITE 501
OKLAHOMA CITY OK
73116-1684
US

V. Phone/Fax

Practice location:
  • Phone: 405-840-5252
  • Fax: 405-840-1256
Mailing address:
  • Phone: 405-840-5252
  • Fax: 405-840-1256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number13
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number95-249
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: