Provider Demographics
NPI:1013090620
Name:WHITSITT, THOMAS MICHAEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:WHITSITT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5569 S LEWIS AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-7132
Mailing Address - Country:US
Mailing Address - Phone:918-742-6050
Mailing Address - Fax:866-996-9954
Practice Address - Street 1:5569 S LEWIS AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-7132
Practice Address - Country:US
Practice Address - Phone:918-742-6050
Practice Address - Fax:866-996-9954
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK686106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist