MEDICARE: CONCEPTS IN WELL BEING

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	251S00000X	Community/Behavioral Health Agency	002196	OK

General Provider Information

NPI Number	:	1841671815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONCEPTS IN WELL BEING

Provider Business Mailing Address
First Line	:	3729 NW 64TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-1913
Country	:	US
Telephone Number	:	405-620-7740
Fax Number	:	405-752-7339

Provider Business Practice Location Address
First Line	:	3729 NW 64TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-1913
Country	:	US
Telephone Number	:	405-620-7740
Fax Number	:	405-752-7339

Authorized Official
Title or Position	:	OWNER
Name	:	WILLIAM T SHAHAN
Credential	:	LCSW
Telephone Number	:	405-620-7740

Provider Enumeration Date	:	06/15/2015
Last Update Date	:	06/15/2015

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Directions to “CONCEPTS IN WELL BEING ” Practice Location

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