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General NPI Number Information
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NPI Number | 1679287320
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Entity Type | Organization
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Legal Business Name | FORGE THERAPY PLLC
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Dates
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Enumeration Date | 01/09/2023
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 9905 S PENNSYLVANIA AVE STE A
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City | OKLAHOMA CITY
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State | OK
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Zip | 73159-6920
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Country | US
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Telephone | 405-254-6206
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Fax | 405-497-6794
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Provider Business Mailing Address
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Address Line | 5030 N MAY AVE STE 378
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-6010
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Country | US
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Telephone | 405-254-6206
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Fax | 405-497-6794
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MR. ANDREW C BENTLEY
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Credential | MSW, LCSW
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Telephone | 405-254-6206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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