Christy Diane Byrd, LMFT

Individual provider Active NPI Marriage & Family Therapist · Noble, OK

NPI 1871702258 · NPPES record last updated Aug 16, 2018

Key facts

NPI
1871702258
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
928 (OK)
Practice address
115 S Main St
Noble, OK 73068
Phone
(405) 568-2003
Fax
(405) 872-8466
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
928OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Counseling Center LLC Marriage & Family Therapist Past
since Sep 22, 2015
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 928 OK Yes

Addresses

Primary practice location

115 S Main St
Noble, OK 73068

Mailing address

PO Box 196
Noble, OK 73068-0196
Phone (405) 568-2003

Other identifiers

IdentifierTypeStateIssuer
200260590BMedicaidOK

Other providers in Noble, OK

All providers in Noble, OK · Marriage & Family Therapist in Oklahoma

Sources for this page

Verify at the official NPI Registry.