Basic Information
Provider Information
NPI: 1861611857
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARNAT
FirstName: REBECCA
MiddleName: DIANE
NamePrefix: MRS.
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: EDWARDS
OtherFirstName: REBECCA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: LPC
OtherLastNameType: 1
Mailing Information
Address1: 650 S PEORIA
Address2:  
City: TULSA
State: OK
PostalCode: 741204429
CountryCode: US
TelephoneNumber: 9185879471
FaxNumber: 9185600137
Practice Location
Address1: 650 S PEORIA AVE
Address2:  
City: TULSA
State: OK
PostalCode: 74120
CountryCode: US
TelephoneNumber: 9185879471
FaxNumber: 9185601399
Other Information
ProviderEnumerationDate: 04/25/2007
LastUpdateDate: 08/02/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X4353OKY Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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