Healthy Life Interventions LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4904 Issued in OK

Legal business name

HEALTHY LIFE INTERVENTIONS LLC

Practice address

4010 N Lincoln Blvd
Suite 120
Oklahoma City, OK 73105-5220

Phone

(405) 274-5031

Fax

(405) 310-1791

NPI assigned

Jul 20, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Dewone Everett Bennett Jr., M.S, LPC

Title

Executive Director

Phone

(405) 274-5031

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1831531789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 N LINCOLN BLVD STE 120",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731055214",
            "telephone_number": "405-274-5031",
            "fax_number": "405-310-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 N LINCOLN BLVD",
            "address_2": "SUITE 120",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731055220",
            "telephone_number": "405-274-5031",
            "fax_number": "405-310-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIFE INTERVENTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-20",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "DEWONE",
        "authorized_official_middle_name": "EVERETT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "405-274-5031",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.S, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "4904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200496140B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Oklahoma City, OK
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.