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General NPI Number Information
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NPI Number | 1487478335
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Entity Type | Organization
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Legal Business Name | BE WELL PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 4867 S SHERIDAN RD STE 717
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City | TULSA
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State | OK
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Zip | 74145-5721
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Country | US
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Telephone | 918-516-8156
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Fax |
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Provider Business Mailing Address
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Address Line | 1216 E KENOSHA ST # 216
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City | BROKEN ARROW
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State | OK
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Zip | 74012-2007
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Country | US
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Telephone | 832-372-5115
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Fax |
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Authorized Official
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Title or Position | FOUNDER/OWNER
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Name | RANELLE MONTERRY BRACY-LEWIS
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Credential | DO
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Telephone | 832-372-5115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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