Healthcare Provider Details

I. General information

NPI: 1982734505
Provider Name (Legal Business Name): DONALD SCOTT HEFFINGTON MS, LPC, LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 10/13/2021
Certification Date: 10/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8001 S MINGO RD APT 1103
TULSA OK
74133-0819
US

IV. Provider business mailing address

8001 S MINGO RD APT 1103
TULSA OK
74133-0819
US

V. Phone/Fax

Practice location:
  • Phone: 918-510-1708
  • Fax:
Mailing address:
  • Phone: 918-510-1708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number47
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3103
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: