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NPI Code Detail

MEDICARE: MICHAEL HUMPHRIES M.S.CCC-SLP, BCBA & ASSOCIATES PLLC

MEDICARE: MICHAEL HUMPHRIES M.S.CCC-SLP, BCBA & ASSOCIATES PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist
2103K00000XBehavior Analyst
3235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1649058736
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHAEL HUMPHRIES M.S.CCC-SLP, BCBA & ASSOCIATES PLLC
Provider Business Mailing Address
First Line : 9031 SW 29TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73179-2818
Country : US
Telephone Number : 405-652-9683
Fax Number :
Provider Business Practice Location Address
First Line : 9031 SW 29TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73179-2818
Country : US
Telephone Number : 405-464-8484
Fax Number : 405-883-3061
Authorized Official
Title or Position : CLINICAL DIRECTOR
Name : MICHAEL WARD HUMPHRIES
Credential : M.S. CCC-SLP, BCBA
Telephone Number : 405-652-9683
Provider Enumeration Date : 09/19/2023
Last Update Date : 04/13/2026

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