Provider Demographics
NPI:1407463821
Name:CATHOLIC CHARITIES OF THE DIOCESE OF TULSA
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES OF THE DIOCESE OF TULSA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF COUNSELING SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:918-884-4536
Mailing Address - Street 1:2450 N HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74115-3140
Mailing Address - Country:US
Mailing Address - Phone:918-949-4673
Mailing Address - Fax:
Practice Address - Street 1:2450 N HARVARD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74115-3140
Practice Address - Country:US
Practice Address - Phone:918-949-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health