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Individual

AVERY JOEL FENNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2617 GENERAL PERSHING BLVD, OKLAHOMA CITY, OK 73107-6437
(405) 858-2700
Mailing address
PO BOX 12978, OKLAHOMA CITY, OK 73157-2978

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
OK
101YM0800X
Mental Health Counselor
OK
175T00000X
Peer Specialist
Primary
OK

Other

Enumeration date
04/15/2022
Last updated
03/30/2026
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