MEDICARE: MIND WORKS CONSULTING AND PSYCHOLOGICAL SERVICES

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	103TC0700X	Clinical Psychologist	1207	OK

General Provider Information

NPI Number	:	1730545153
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND WORKS CONSULTING AND PSYCHOLOGICAL SERVICES

Provider Business Mailing Address
First Line	:	13331 N MACARTHUR BLVD
Second Line	:	APT 508
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73142-3033
Country	:	US
Telephone Number	:	650-450-7904
Fax Number	:

Provider Business Practice Location Address
First Line	:	11901 N MACARTHUR BLVD STE C
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-1806
Country	:	US
Telephone Number	:	650-450-7904
Fax Number	:

Authorized Official
Title or Position	:	LICENSED CLINICAL PSYCHOLOGIST
Name	:	DR. JENNIFER LAUREN SWEETON
Credential	:	PSY.D.
Telephone Number	:	650-450-7904

Provider Enumeration Date	:	01/14/2016
Last Update Date	:	01/14/2016

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