Provider Demographics
NPI:1770227753
Name:BRENT FERRIS LLC
Entity Type:Organization
Organization Name:BRENT FERRIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:405-821-4929
Mailing Address - Street 1:12220 N MACARTHUR BLVD STE F9
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-1850
Mailing Address - Country:US
Mailing Address - Phone:405-821-4929
Mailing Address - Fax:405-242-3481
Practice Address - Street 1:12220 N MACARTHUR BLVD STE F9
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-1850
Practice Address - Country:US
Practice Address - Phone:405-821-4929
Practice Address - Fax:405-242-3481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty