Provider Demographics
NPI:1891989885
Name:WILLIS,, DAVID STEEL III (LPC, NCP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:STEEL
Last Name:WILLIS,
Suffix:III
Gender:M
Credentials:LPC, NCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3751 E 85TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-1734
Mailing Address - Country:US
Mailing Address - Phone:918-520-5476
Mailing Address - Fax:
Practice Address - Street 1:3751 E 85TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-1734
Practice Address - Country:US
Practice Address - Phone:918-520-5476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-01
Last Update Date:2007-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3645101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional