Provider Demographics
NPI:1841583978
Name:MENTAL HEALTH ASSOCIATION IN TULSA
Entity Type:Organization
Organization Name:MENTAL HEALTH ASSOCIATION IN TULSA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR DENVER HOUSE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MAXWELL
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:918-382-2470
Mailing Address - Street 1:3326 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-1907
Mailing Address - Country:US
Mailing Address - Phone:918-704-8706
Mailing Address - Fax:
Practice Address - Street 1:3326 E 22ND ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-1907
Practice Address - Country:US
Practice Address - Phone:918-704-8706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3996251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health