Provider Demographics
NPI:1972028223
Name:NASH, CHRISTOPHER WILLIAM JR (NPC UNDER SUPERVISIO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:WILLIAM
Last Name:NASH
Suffix:JR
Gender:M
Credentials:NPC UNDER SUPERVISIO
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:CHEADLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:RESOURCE MANAGEMENT
Mailing Address - Street 2:1300 HOPPE BLVD., SUITE 1
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820
Mailing Address - Country:US
Mailing Address - Phone:580-436-7211
Mailing Address - Fax:580-272-5757
Practice Address - Street 1:1300 HOPPE BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820
Practice Address - Country:US
Practice Address - Phone:580-436-1222
Practice Address - Fax:580-436-1333
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7256101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional