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General NPI Number Information
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NPI Number | 1770386203
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Entity Type | Organization
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Legal Business Name | SCRIPTED MIND INC
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 5840 S MEMORIAL DR STE 330
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City | TULSA
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State | OK
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Zip | 74145-9060
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Country | US
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Telephone | 918-200-9830
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Fax | 918-601-8103
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Provider Business Mailing Address
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Address Line | 5840 S MEMORIAL DR STE 330
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City | TULSA
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State | OK
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Zip | 74145-9060
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Country | US
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Telephone | 918-200-9830
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Fax | 918-601-8103
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MR. DESMOND ERIC KETTER
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Credential | LPC
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Telephone | 918-645-6064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health 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 | 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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