Healthcare Provider Details

I. General information

NPI: 1518789874
Provider Name (Legal Business Name): TULSA METRO PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4870 S LEWIS AVE STE 240
TULSA OK
74105-5153
US

IV. Provider business mailing address

4870 S LEWIS AVE STE 240
TULSA OK
74105-5153
US

V. Phone/Fax

Practice location:
  • Phone: 918-982-6524
  • Fax: 539-399-7559
Mailing address:
  • Phone: 918-982-6524
  • Fax: 539-399-7559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: HANNAH LAWRENCE
Title or Position: OWNER, OFFICE MANAGER
Credential:
Phone: 918-982-6524