Organization
PRIVATE PSYCHIATRIC CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SELENA MELANESE PARKS (CEO)
(405) 708-6999
Entity
Organization
Contact information
Practice address
907 S DETROIT AVE STE 1075, TULSA, OK 74120-4276
(918) 856-3436
(877) 245-1779
Mailing address
4845 S SHERIDAN RD, 504, TULSA, OK 74145-5751
(918) 856-3436
(877) 245-1779
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
08/02/2011
Last updated
04/16/2018
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