Provider Demographics
NPI:1841787686
Name:OUTDOOR ACHIEVEMENT GROUP, L.L.C.
Entity type:Organization
Organization Name:OUTDOOR ACHIEVEMENT GROUP, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WHITAKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:405-361-1754
Mailing Address - Street 1:10401 S TRAFALGAR DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-5508
Mailing Address - Country:US
Mailing Address - Phone:405-361-1754
Mailing Address - Fax:405-563-9511
Practice Address - Street 1:8265 S WALKER AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-9451
Practice Address - Country:US
Practice Address - Phone:405-361-1754
Practice Address - Fax:405-563-9511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-17
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty