Healthcare Provider Details

I. General information

NPI: 1568943868
Provider Name (Legal Business Name): AMY MICHELLE NIMMO LPC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2018
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 N 7TH AVE
PURCELL OK
73080-2215
US

IV. Provider business mailing address

4220 SHORELINE CIR
NORMAN OK
73026-1302
US

V. Phone/Fax

Practice location:
  • Phone: 405-527-2122
  • Fax:
Mailing address:
  • Phone: 580-695-1550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: