Provider Demographics
NPI:1982964920
Name:CRONINGER, DAVID MICHAEL (D MIN)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:CRONINGER
Suffix:
Gender:M
Credentials:D MIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 N. BROOKLINE AVE.
Mailing Address - Street 2:SUITE 620
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112
Mailing Address - Country:US
Mailing Address - Phone:405-226-8509
Mailing Address - Fax:405-322-5377
Practice Address - Street 1:5100 N BROOKLINE AVE
Practice Address - Street 2:SUITE 620
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-3623
Practice Address - Country:US
Practice Address - Phone:405-226-8509
Practice Address - Fax:405-322-5377
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2016-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK418101YA0400X
OK239106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist