| Senior Psychological Care Of Oklahoma, Llc | |
|
6202 E 61st St Tulsa OK 74136-2119 | |
| (713) 850-0049 | |
| Not Available |
| Full Name | Senior Psychological Care Of Oklahoma, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 6202 E 61st St, Tulsa, Oklahoma |
| Authorized Official Name and Position | Randall J. Frapart (COO/CFO) |
| Authorized Official Contact | 7138500049 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Psychological Care Of Oklahoma, Llc 4635 Southwest Fwy Ste 635 Houston TX 77027-7112 Ph: (713) 850-0049 | Senior Psychological Care Of Oklahoma, Llc 6202 E 61st St Tulsa OK 74136-2119 Ph: (713) 850-0049 |
| NPI Number | 1740931609 |
|---|---|
| Provider Enumeration Date | 01/12/2022 |
| Last Update Date | 01/12/2022 |
| Certification Date | 01/12/2022 |
| Medicare PECOS PAC ID | 7214311448 |
|---|---|
| Medicare Enrollment ID | O20220907001133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740931609 | NPI | - | NPPES |
| Provider Name | Crystal Crabb-mcmikel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477858595 PECOS PAC ID: 9133487226 Enrollment ID: I20171219001250 |
| Provider Name | Jane Montanaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992139869 PECOS PAC ID: 3870986706 Enrollment ID: I20220216002875 |
| Provider Name | Laura K Wise |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932577277 PECOS PAC ID: 9537511159 Enrollment ID: I20240119001130 |
| Provider Name | Kara Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225423049 PECOS PAC ID: 7315384971 Enrollment ID: I20240319002673 |
| Provider Name | Tasha Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407274400 PECOS PAC ID: 7517402654 Enrollment ID: I20240712001008 |
| Provider Name | David Painter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912118332 PECOS PAC ID: 4981136231 Enrollment ID: I20241011002577 |
| Provider Name | Haley Harmer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598154221 PECOS PAC ID: 4880128586 Enrollment ID: I20241115003796 |
| Provider Name | Karen Dodd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912275447 PECOS PAC ID: 8729502026 Enrollment ID: I20250408002710 |
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