Basic Information
Provider Information
NPI: 1205392693
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AKPIRI
FirstName: VIVIAN
MiddleName: EBEHITHALE
NamePrefix: MRS.
NameSuffix:  
Credential: MHR
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5804 NW 160TH ST
Address2:  
City: EDMOND
State: OK
PostalCode: 730139400
CountryCode: US
TelephoneNumber: 5805741683
FaxNumber:  
Practice Location
Address1: 2220 N CLASSEN BLVD STE E
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731065810
CountryCode: US
TelephoneNumber: 4055281748
FaxNumber: 4055281802
Other Information
ProviderEnumerationDate: 02/11/2019
LastUpdateDate: 02/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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