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General NPI Number Information
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NPI Number | 1578479846
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Entity Type | Organization
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Legal Business Name | EMPACT THERAPEUTIC SERVICES, LLC
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 3351 W ROCK CREEK RD STE 130
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City | NORMAN
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State | OK
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Zip | 73072-2463
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Country | US
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Telephone | 405-217-2102
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Fax |
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Provider Business Mailing Address
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Address Line | 3351 W ROCK CREEK RD STE 130
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City | NORMAN
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State | OK
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Zip | 73072-2463
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TAYLOR WHALEY
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Credential |
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Telephone | 405-217-2102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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