Individual
MISTY DAWN FELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW-P
Contact information
Practice address
6100 S WALKER AVE, OKLAHOMA CITY, OK 73139-7026
(405) 634-4400
Mailing address
6100 S WALKER AVE, OKLAHOMA CITY, OK 73139-7026
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
Primary
—
—
106S00000X
Behavior Technician
—
—
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236
—
DC
01
—
568946544
BCBS
—
01
—
5874
HEALTH PARTNERS
—
Enumeration date
06/13/2024
Last updated
06/14/2024
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