MEDICARE: DR. WILLIAM DYCUS PH.D.

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
1	103TB0200X	Cognitive & Behavioral Psychologist	3064	NC
2	103TC0700X	Clinical Psychologist	3064	NC
3	103TC1900X	Counseling Psychologist	3064	NC
4	103TC2200X	Clinical Child & Adolescent Psychologist	3064	NC
5	103TF0000X	Family Psychologist	3064	NC
6	103T00000X	Psychologist	3064	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649221896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM DYCUS PH.D.

Provider Business Mailing Address
First Line	:	435 NW 19TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73103-1911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 NW 19TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73103-1911
Country	:	US
Telephone Number	:	405-343-9407
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	09/11/2025

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