Provider Demographics
NPI:1851658959
Name:FOCUS MENTAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:FOCUS MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FREDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-214-0016
Mailing Address - Street 1:33207 45TH ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-3423
Mailing Address - Country:US
Mailing Address - Phone:405-214-0116
Mailing Address - Fax:877-334-8552
Practice Address - Street 1:1127 N KICKAPOO AVE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-4845
Practice Address - Country:US
Practice Address - Phone:405-214-0116
Practice Address - Fax:877-334-8552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4469101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1427388313OtherNPI