Healthcare Provider Details

I. General information

NPI: 1770386203
Provider Name (Legal Business Name): SCRIPTED MIND INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5840 S MEMORIAL DR STE 330
TULSA OK
74145-9060
US

IV. Provider business mailing address

5840 S MEMORIAL DR STE 330
TULSA OK
74145-9060
US

V. Phone/Fax

Practice location:
  • Phone: 918-200-9830
  • Fax: 918-601-8103
Mailing address:
  • Phone: 918-200-9830
  • Fax: 918-601-8103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. DESMOND ERIC KETTER
Title or Position: CLINICAL DIRECTOR
Credential: LPC
Phone: 918-645-6064