Healthcare Provider Details
I. General information
NPI: 1447413513
Provider Name (Legal Business Name): OKLAHOMA MENTAL HEALTH COUNCIL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2008
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4400 N LINCOLN BLVD
OKLAHOMA CITY OK
73105-5104
US
IV. Provider business mailing address
4400 N LINCOLN BLVD
OKLAHOMA CITY OK
73105-5104
US
V. Phone/Fax
- Phone: 405-424-7711
- Fax: 405-425-0441
- Phone: 405-424-7711
- Fax: 405-425-0441
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ALLYN
S
FRIEDMAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LPC LMFT
Phone: 405-425-0355