Provider Demographics
NPI:1205026804
Name:G MICHAEL AND CYNTHIA M KAMPSCHAEFER PC
Entity Type:Organization
Organization Name:G MICHAEL AND CYNTHIA M KAMPSCHAEFER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KAMPSCHAEFER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:405-810-1133
Mailing Address - Street 1:1900 NW EXPRESSWAY ST
Mailing Address - Street 2:STE. 900
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-1802
Mailing Address - Country:US
Mailing Address - Phone:405-810-1133
Mailing Address - Fax:405-810-1155
Practice Address - Street 1:1900 NW EXPRESSWAY ST
Practice Address - Street 2:STE. 900
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-1802
Practice Address - Country:US
Practice Address - Phone:405-810-1133
Practice Address - Fax:405-810-1155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK375102L00000X, 103T00000X, 103TA0400X, 103TA0700X, 103TC0700X, 103TC1900X, 103TC2200X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty