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General NPI Number Information
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NPI Number | 1831053131
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Entity Type | Organization
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Legal Business Name | MOSAIC FAMILY THERAPY, PLLC
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Dates
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Enumeration Date | 12/11/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 6711 S YALE AVE STE 106
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City | TULSA
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State | OK
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Zip | 74136-3317
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Country | US
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Telephone | 918-606-1314
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Fax | 539-233-1536
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Provider Business Mailing Address
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Address Line | 12515 E 134TH ST S
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City | BROKEN ARROW
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State | OK
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Zip | 74011-7437
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Country | US
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Telephone | 918-606-1314
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Fax | 539-233-1536
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LESLIE KEENAN
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Credential | LMFT
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Telephone | 918-606-1314
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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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