Provider Demographics
NPI:1477884971
Name:CONYERS, ERNEST HAROLD II (LMFTUS)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:HAROLD
Last Name:CONYERS
Suffix:II
Gender:M
Credentials:LMFTUS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 S BOSTON AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74110
Mailing Address - Country:US
Mailing Address - Phone:918-561-6000
Mailing Address - Fax:918-561-6001
Practice Address - Street 1:1516 S BOSTON AVE
Practice Address - Street 2:STE 100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-4003
Practice Address - Country:US
Practice Address - Phone:918-561-6000
Practice Address - Fax:918-561-6001
Is Sole Proprietor?:No
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist