| Brickhouse Therapy Solutions, Llc | |
|
214 N Oklahoma Ave Shawnee OK 74801-7030 | |
| (405) 481-0447 | |
| Not Available |
| Full Name | Brickhouse Therapy Solutions, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 214 N Oklahoma Ave, Shawnee, Oklahoma |
| Authorized Official Name and Position | Shaya Harris (OWNER) |
| Authorized Official Contact | 4054810447 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brickhouse Therapy Solutions, Llc 214 N Oklahoma Ave Shawnee OK 74801-7030 Ph: (405) 481-0447 | Brickhouse Therapy Solutions, Llc 214 N Oklahoma Ave Shawnee OK 74801-7030 Ph: (405) 481-0447 |
| NPI Number | 1376246306 |
|---|---|
| Provider Enumeration Date | 03/27/2023 |
| Last Update Date | 03/27/2023 |
| Certification Date | 03/27/2023 |
| Medicare PECOS PAC ID | 1355707506 |
|---|---|
| Medicare Enrollment ID | O20230515001827 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376246306 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Shaya Leigh Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790346641 PECOS PAC ID: 7315316981 Enrollment ID: I20221205000804 |
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