TULSA PROFESSIONAL PSYCHOLOGY PLLC NPI 1629569264

NPI Information

  • NPI: 1629569264
  • Provider Name: TULSA PROFESSIONAL PSYCHOLOGY, PLLC
  • Classification: Psychologist - 103TH0100X
  • Specialization: Health Service
  • Entity Type: Organization
  • Doing Business As: GREEN COUNTRY PSYCHOLOGY
  • Address: 3144 S WINSTON AVE STE A
    TULSA, OK
    ZIP 74135
  • Phone: (918) 878-8072

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NPI Details

TULSA PROFESSIONAL PSYCHOLOGY, PLLC is a health service psychologist in Tulsa, OK. The provider is a psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). TULSA PROFESSIONAL PSYCHOLOGY, PLLC NPI is 1629569264. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Green Country Psychology.

The provider's business location address is:

3144 S WINSTON AVE STE A
TULSA, OK
ZIP 74135-012
Phone: (918) 878-8072
Fax: (918) 878-8072

The provider's authorized official is Timothy Doty .
The authorized official title is Co-president and has the following contact phone number (918) 878-8072.

The enumeration date for this NPI number is 5/18/2018 and was last updated on 5/18/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinical1118OKLAHOMANo
2103TC0700XPsychologistClinical1225OKLAHOMANo
3103TF0200XPsychologistForensic1118OKLAHOMANo
4103TH0100XPsychologistHealth Service1118OKLAHOMAYes
5103TH0100XPsychologistHealth Service1225OKLAHOMANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200460890BMEDICAIDOKLAHOMA
2200466160AMEDICAIDOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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