1144551714 NPI number — MS. MELISSA GAIL FRITTS WINKLER MS; LMFT

Table of content: MS. MELISSA GAIL FRITTS WINKLER MS; LMFT (NPI 1144551714)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144551714 NPI number — MS. MELISSA GAIL FRITTS WINKLER MS; LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRITTS WINKLER
Provider First Name:
MELISSA
Provider Middle Name:
GAIL
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS; LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144551714
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 826
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PAULS VALLEY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73075-0826
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-695-5525
Provider Business Mailing Address Fax Number:
405-926-2089

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
513 S WILLOW ST STE 6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PAULS VALLEY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73075-3849
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-695-5525
Provider Business Practice Location Address Fax Number:
450-926-2089
Provider Enumeration Date:
01/21/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  1147 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100734740-F , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".