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General NPI Number Information
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NPI Number | 1790563963
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Entity Type | Organization
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Legal Business Name | ENVISION THERAPIES LLC
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 303 N BROADWAY ST
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City | CLEVELAND
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State | OK
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Zip | 74020-3421
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Country | US
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Telephone | 405-584-2185
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Fax |
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Provider Business Mailing Address
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Address Line | 303 N BROADWAY ST
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City | CLEVELAND
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State | OK
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Zip | 74020-3421
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Country | US
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Telephone | 539-209-1209
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Fax | 539-203-3672
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | MRS. NATASHA NICOLE HAMILTON
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Credential | LCSW
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Telephone | 539-209-1209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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