Provider Demographics
NPI:1295261402
Name:AMADO, QUANTONA (MS, MHA, MLS, LPC)
Entity type:Individual
Prefix:
First Name:QUANTONA
Middle Name:
Last Name:AMADO
Suffix:
Gender:F
Credentials:MS, MHA, MLS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 580700
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74158-0700
Mailing Address - Country:US
Mailing Address - Phone:918-430-0975
Mailing Address - Fax:
Practice Address - Street 1:1219 N SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-5333
Practice Address - Country:US
Practice Address - Phone:405-355-8408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-08
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YA0400X
OK06974101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)