| Audacity Therapy | |
|
2221 Westpark Dr Ste C Norman OK 73069-4071 | |
| (405) 888-8167 | |
| (405) 592-7839 |
| Full Name | Audacity Therapy |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2221 Westpark Dr Ste C, Norman, Oklahoma |
| Authorized Official Name and Position | Lauren Park (OWNER) |
| Authorized Official Contact | 4058888167 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Audacity Therapy 2221 Westpark Dr Ste C Norman OK 73069-4071 Ph: (405) 888-8167 | Audacity Therapy 2221 Westpark Dr Ste C Norman OK 73069-4071 Ph: (405) 888-8167 |
| NPI Number | 1679333231 |
|---|---|
| Provider Enumeration Date | 03/20/2024 |
| Last Update Date | 12/02/2024 |
| Certification Date | 12/02/2024 |
| Medicare PECOS PAC ID | 9638606841 |
|---|---|
| Medicare Enrollment ID | O20241230003555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679333231 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | () | Primary |
| Provider Name | Lauren Park |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679208581 PECOS PAC ID: 0547797755 Enrollment ID: I20241230003559 |
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