Provider Demographics
NPI:1558683243
Name:ADAIR, AMY ELIZABETH (LPC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ELIZABETH
Last Name:ADAIR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:ELIZABETH
Other - Last Name:SCHAEFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:5705 NW 132ND ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-4437
Mailing Address - Country:US
Mailing Address - Phone:405-819-0111
Mailing Address - Fax:405-607-1339
Practice Address - Street 1:5705 NW 132ND ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-4437
Practice Address - Country:US
Practice Address - Phone:405-819-0111
Practice Address - Fax:405-607-1339
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1640101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100849000BMedicaid