Gerald Wayne Atchley, MHR, LPC

Individual provider Active NPI Mental Health Counselor · Sand Springs, OK

NPI 1023212370 · NPPES record last updated Jun 17, 2010

Key facts

NPI
1023212370
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
2622 (OK)
Practice address
20866 W. 71 St
Sand Springs, OK 74063
Phone
(918) 637-4389
NPI assigned
Jun 12, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2622OKMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2622 OK Yes

Addresses

Primary practice location

20866 W. 71 St
Sand Springs, OK 74063

Mailing address

20866 W. 71 St
Sand Springs, OK 74063
Phone (918) 637-4389

Other providers in Sand Springs, OK

All providers in Sand Springs, OK · Mental Health Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.