Provider Demographics
NPI:1609008275
Name:MOBLEY, EMILY (MHR, LPC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MOBLEY
Suffix:
Gender:F
Credentials:MHR, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7521 S OLYMPIA AVE # 1054
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74132-1855
Mailing Address - Country:US
Mailing Address - Phone:918-960-0679
Mailing Address - Fax:
Practice Address - Street 1:9717 E 42ND ST STE 208
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-3680
Practice Address - Country:US
Practice Address - Phone:918-960-0679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5264101Y00000X, 101YP2500X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100734620Medicaid