Provider Demographics
NPI:1013737964
Name:FATIHAH, JENEL (LMSW-P U/S)
Entity type:Individual
Prefix:
First Name:JENEL
Middle Name:
Last Name:FATIHAH
Suffix:
Gender:F
Credentials:LMSW-P U/S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 S FULTON AVE STE A1
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-6905
Mailing Address - Country:US
Mailing Address - Phone:539-525-0078
Mailing Address - Fax:
Practice Address - Street 1:4901 S FULTON AVE STE A1
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-6905
Practice Address - Country:US
Practice Address - Phone:539-525-0078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health