Provider Demographics
NPI:1679279525
Name:ACT FAMILY THERAPY
Entity type:Organization
Organization Name:ACT FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ROBBINS
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:MS LMFT
Authorized Official - Phone:405-820-7272
Mailing Address - Street 1:1491 S SUNNYLANE RD RM 208
Mailing Address - Street 2:
Mailing Address - City:DEL CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73115-3037
Mailing Address - Country:US
Mailing Address - Phone:405-820-7272
Mailing Address - Fax:
Practice Address - Street 1:1491 S SUNNYLANE RD RM 208
Practice Address - Street 2:
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115-3037
Practice Address - Country:US
Practice Address - Phone:405-820-7272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1364OtherOKLAHOMA BOARD OF BEHAVIORAL HEALTH