Provider Demographics
NPI:1235606393
Name:UPTOWN COUNSELING LLC
Entity Type:Organization
Organization Name:UPTOWN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHELAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:405-310-7463
Mailing Address - Street 1:616 NW 21ST ST STE 105
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-1861
Mailing Address - Country:US
Mailing Address - Phone:405-310-7463
Mailing Address - Fax:405-494-8618
Practice Address - Street 1:416 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-1508
Practice Address - Country:US
Practice Address - Phone:405-310-7463
Practice Address - Fax:405-494-8618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-26
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1629327358OtherNPI 1