Provider Demographics
NPI:1568743151
Name:MOSINDI, AUGUSTINE UMEADI (BSC, MA, MHP, BHCM 3)
Entity Type:Individual
Prefix:MR
First Name:AUGUSTINE
Middle Name:UMEADI
Last Name:MOSINDI
Suffix:
Gender:M
Credentials:BSC, MA, MHP, BHCM 3
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16220 EVERGLADE LN
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1259
Mailing Address - Country:US
Mailing Address - Phone:405-209-3575
Mailing Address - Fax:
Practice Address - Street 1:16220 EVERGLADE LN
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-1259
Practice Address - Country:US
Practice Address - Phone:405-525-0452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5894101YP2500X
OK9913103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional