Healthcare Provider Details

I. General information

NPI: 1174843080
Provider Name (Legal Business Name): OKLAHOMA MENTAL HEALTH CONSUMER COUNCIL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 06/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 NW 48TH ST SUITE 102
OKLAHOMA CITY OK
73112-5900
US

IV. Provider business mailing address

3200 NW 48TH STREET SUITE 102
OKLAHOMA CITY OK
73112-5911
US

V. Phone/Fax

Practice location:
  • Phone: 405-604-6975
  • Fax: 405-605-8175
Mailing address:
  • Phone: 405-604-6975
  • Fax: 405-605-8175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. BECKY K TALLENT
Title or Position: EXECUTIVE DIRECTOR
Credential: JD
Phone: 405-604-6975