Provider Demographics
NPI:1881016772
Name:KATIGAN, FORREST BRENT (LADC/MH)
Entity type:Individual
Prefix:
First Name:FORREST
Middle Name:BRENT
Last Name:KATIGAN
Suffix:
Gender:M
Credentials:LADC/MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 W ABI RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:OK
Mailing Address - Zip Code:73093-9704
Mailing Address - Country:US
Mailing Address - Phone:405-664-7857
Mailing Address - Fax:
Practice Address - Street 1:10400 GREENBRIAR PL # 101
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7637
Practice Address - Country:US
Practice Address - Phone:405-664-7857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-10
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK992101YM0800X, 171M00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator