Provider Demographics
NPI:1124917661
Name:CREOKS MENTAL HEALTH SERVICES
Entity type:Organization
Organization Name:CREOKS MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FSP
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-691-1706
Mailing Address - Street 1:11839 N 107 E AVE.
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74021
Mailing Address - Country:US
Mailing Address - Phone:918-691-1706
Mailing Address - Fax:
Practice Address - Street 1:2548 E 71ST ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74014
Practice Address - Country:US
Practice Address - Phone:918-691-1706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty