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General NPI Number Information
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NPI Number | 1790246619
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Entity Type | Organization
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Legal Business Name | TULSA FAMILY PSYCHIATRY & WELLNESS, INC
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 2526 E 71ST ST STE J
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City | TULSA
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State | OK
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Zip | 74136-5576
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Country | US
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Telephone | 918-268-9578
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Fax | 918-471-2854
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Provider Business Mailing Address
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Address Line | 2526 E 71ST ST STE J
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City | TULSA
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State | OK
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Zip | 74136-5576
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Country | US
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Telephone | 918-268-9578
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Fax | 918-471-2854
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Authorized Official
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Title or Position | CEO
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Name | SCOTT M FISHER
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Credential | MHA
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Telephone | 918-268-9578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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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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Taxonomy #3
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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 #4
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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