Provider Demographics
NPI:1306010640
Name:STONEBRIDGE FAMILY SERVICES, PC
Entity Type:Organization
Organization Name:STONEBRIDGE FAMILY SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:405-708-3640
Mailing Address - Street 1:530 POINTE PARKWAY BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-0600
Mailing Address - Country:US
Mailing Address - Phone:405-708-3640
Mailing Address - Fax:
Practice Address - Street 1:530 POINTE PARKWAY BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-0600
Practice Address - Country:US
Practice Address - Phone:405-708-3640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
OK896106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty