Provider Demographics
NPI:1932728839
Name:TREY TROTTER, LMFT & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:TREY TROTTER, LMFT & ASSOCIATES, LLC
Other - Org Name:TREY TROTTER, LMFT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TREY
Authorized Official - Middle Name:
Authorized Official - Last Name:TROTTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:580-765-8739
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:DISNEY
Mailing Address - State:OK
Mailing Address - Zip Code:74340-0032
Mailing Address - Country:US
Mailing Address - Phone:580-765-8739
Mailing Address - Fax:580-749-4131
Practice Address - Street 1:5840 S MEMORIAL DR STE 3001
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-9054
Practice Address - Country:US
Practice Address - Phone:580-765-8739
Practice Address - Fax:580-749-4131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-10
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1548579378Medicaid