Provider Demographics
NPI:1164780193
Name:THE SEQUOYAH GROUP
Entity Type:Organization
Organization Name:THE SEQUOYAH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:405-471-9301
Mailing Address - Street 1:1037 NW 166TH TER
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-6807
Mailing Address - Country:US
Mailing Address - Phone:405-471-9301
Mailing Address - Fax:405-330-7812
Practice Address - Street 1:2912 S DOUGLAS BLVD
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-7179
Practice Address - Country:US
Practice Address - Phone:405-471-9301
Practice Address - Fax:405-330-7812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK263251B00000X
OK163251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management