Healthcare Provider Details

I. General information

NPI: 1568373827
Provider Name (Legal Business Name): ROSE ROCK PSYCHIATRY & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S MISSION ST STE A
SAPULPA OK
74066-4657
US

IV. Provider business mailing address

601 S MISSION ST STE A
SAPULPA OK
74066-4657
US

V. Phone/Fax

Practice location:
  • Phone: 918-347-7437
  • Fax:
Mailing address:
  • Phone: 918-347-7437
  • Fax: 539-203-3268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KATRINA ASHBY
Title or Position: OFFICE/OPERATIONS MANAGER
Credential: MANAGER
Phone: 918-991-1577