Healthcare Provider Details

I. General information

NPI: 1730455841
Provider Name (Legal Business Name): LARRY HOCHHAUS PHD, LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2012
Last Update Date: 03/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7950 E 41ST ST
TULSA OK
74145-3215
US

IV. Provider business mailing address

10730 E 28TH PL
TULSA OK
74129-7623
US

V. Phone/Fax

Practice location:
  • Phone: 918-621-1600
  • Fax:
Mailing address:
  • Phone: 918-809-1152
  • Fax: 918-828-0155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number809
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: