Provider Demographics
NPI:1194201723
Name:HEART YOUTH & FAMILY THERAPY, INC.
Entity Type:Organization
Organization Name:HEART YOUTH & FAMILY THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:918-982-3700
Mailing Address - Street 1:3171 S 129TH EAST AVE # A1161
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74134-3205
Mailing Address - Country:US
Mailing Address - Phone:918-502-5240
Mailing Address - Fax:
Practice Address - Street 1:3171 S 129TH EAST AVE # A1161
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74134-3205
Practice Address - Country:US
Practice Address - Phone:918-502-5240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6708251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health