Provider Demographics
NPI:1295113421
Name:MITCHEK, KAREN KNEPPER (MS, EDS)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:KNEPPER
Last Name:MITCHEK
Suffix:
Gender:F
Credentials:MS, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74107-2835
Mailing Address - Country:US
Mailing Address - Phone:918-688-2184
Mailing Address - Fax:
Practice Address - Street 1:4835 S FULTON AVE
Practice Address - Street 2:STE 107
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-6995
Practice Address - Country:US
Practice Address - Phone:918-712-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool