Healthcare Provider Details

I. General information

NPI: 1487478335
Provider Name (Legal Business Name): BE WELL PSYCHIATRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4867 S SHERIDAN RD STE 717
TULSA OK
74145-5721
US

IV. Provider business mailing address

1216 E KENOSHA ST # 216
BROKEN ARROW OK
74012-2007
US

V. Phone/Fax

Practice location:
  • Phone: 918-516-8156
  • Fax:
Mailing address:
  • Phone: 832-372-5115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RANELLE MONTERRY BRACY-LEWIS
Title or Position: FOUNDER/OWNER
Credential: DO
Phone: 832-372-5115