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NPI Code Detail

MEDICARE: AMBER THAXTON LPC

MEDICARE: AMBER THAXTON LPC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1760804579
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER THAXTON LPC
Provider Business Mailing Address
First Line : 8702 S 80TH EAST AVE
Second Line :
City : TULSA
State : OK
Zip : 74133-4823
Country : US
Telephone Number : 918-853-5803
Fax Number :
Provider Business Practice Location Address
First Line : 7633 E 63RD PL STE 300
Second Line :
City : TULSA
State : OK
Zip : 74133-1202
Country : US
Telephone Number : 918-853-5803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2014
Last Update Date : 01/10/2022

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Directions to “ AMBER THAXTON LPC” Practice Location

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