Provider Demographics
NPI:1689193773
Name:RESILIENCE CENTER
Entity Type:Organization
Organization Name:RESILIENCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RYANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:918-861-4973
Mailing Address - Street 1:8988 S SHERIDAN RD STE F
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5035
Mailing Address - Country:US
Mailing Address - Phone:918-861-4973
Mailing Address - Fax:
Practice Address - Street 1:8988 S SHERIDAN RD STE F
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5035
Practice Address - Country:US
Practice Address - Phone:918-861-4973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LITTLE MUSTARDSEED, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4826101YP2500X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty