Healthcare Provider Details

I. General information

NPI: 1174902365
Provider Name (Legal Business Name): JAMES O HALE MS BEHAVIORAL HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2015
Last Update Date: 05/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3035 NW 63RD ST SUITE 200
OKLAHOMA CITY OK
73116-3632
US

IV. Provider business mailing address

PO BOX 57366
OKLAHOMA CITY OK
73157-7366
US

V. Phone/Fax

Practice location:
  • Phone: 405-816-7735
  • Fax: 405-286-1380
Mailing address:
  • Phone: 405-816-7735
  • Fax: 405-286-1380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2262
License Number StateOK

VIII. Authorized Official

Name: JAMES O HALE
Title or Position: PRESIDENT
Credential: MS, LPC, LADC/MH
Phone: 405-816-7735