Provider Demographics
NPI:1235202458
Name:FAMILY RESOURCE GROUP OF EASTERN OKLAHOMA
Entity Type:Organization
Organization Name:FAMILY RESOURCE GROUP OF EASTERN OKLAHOMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPISTS
Authorized Official - Prefix:
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:DELONG
Authorized Official - Last Name:CARONA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:918-492-2385
Mailing Address - Street 1:5110 S YALE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-7401
Mailing Address - Country:US
Mailing Address - Phone:918-492-2385
Mailing Address - Fax:918-492-1579
Practice Address - Street 1:5110 S YALE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-7401
Practice Address - Country:US
Practice Address - Phone:918-492-2385
Practice Address - Fax:918-492-1579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK926101YP2500X
OK466101YP2500X
OK990103TC0700X
OK737103TC0700X
OK508103TC2200X
OK15421041C0700X
OK24721041C0700X
OK21221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty