Provider Demographics
NPI:1366730046
Name:OKLAHOMA COUNSELING AND PSYCHOTHERAPY, LLC
Entity type:Organization
Organization Name:OKLAHOMA COUNSELING AND PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ISENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:405-415-2300
Mailing Address - Street 1:717 NW 56TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-6030
Mailing Address - Country:US
Mailing Address - Phone:405-415-2300
Mailing Address - Fax:405-415-2301
Practice Address - Street 1:717 NW 56TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-6030
Practice Address - Country:US
Practice Address - Phone:405-415-2300
Practice Address - Fax:405-415-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty