Provider Demographics
NPI:1073978029
Name:BRIGHTER OUTLOOK
Entity Type:Organization
Organization Name:BRIGHTER OUTLOOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:LBP
Authorized Official - Phone:918-812-5315
Mailing Address - Street 1:25206 E 64TH ST S
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-2213
Mailing Address - Country:US
Mailing Address - Phone:918-812-5315
Mailing Address - Fax:918-615-6415
Practice Address - Street 1:25206 E 64TH ST S
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74014-2213
Practice Address - Country:US
Practice Address - Phone:918-812-5315
Practice Address - Fax:918-615-6415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-17
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4835101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK2003226780AMedicaid