1801162425 NPI number — TAMARA LOU ALLEN MASTERS COUNSELING

Table of content: TAMARA LOU ALLEN MASTERS COUNSELING (NPI 1801162425)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801162425 NPI number — TAMARA LOU ALLEN MASTERS COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALLEN
Provider First Name:
TAMARA
Provider Middle Name:
LOU
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MASTERS COUNSELING
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COOKE
Provider Other First Name:
TAMARA
Provider Other Middle Name:
LOU
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1801162425
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12005 SW 51ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MUSTANG
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73064-7909
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-978-7892
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16301 SONOMA PARK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDMOND
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73013-2091
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-246-5433
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/28/2012

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: 101YP2500X , with the licence number:  11741 , 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)





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