Provider Demographics
NPI:1235474404
Name:ARMSTRONG, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 E SKELLY DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-6317
Mailing Address - Country:US
Mailing Address - Phone:918-712-0859
Mailing Address - Fax:918-388-6456
Practice Address - Street 1:3015 E SKELLY DR
Practice Address - Street 2:SUITE 103
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-6317
Practice Address - Country:US
Practice Address - Phone:918-712-0859
Practice Address - Fax:918-388-6456
Is Sole Proprietor?:No
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100746170GMedicaid