| Norman Behavioral Health Group, Llc | |
|
712 Wall St Ste 100 Norman OK 73069-6360 | |
| (405) 579-7560 | |
| (405) 579-7563 |
| Full Name | Norman Behavioral Health Group, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 712 Wall St Ste 100, Norman, Oklahoma |
| Authorized Official Name and Position | Robert Monroe Martin (LICENSED PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 4055797560 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Norman Behavioral Health Group, Llc 712 Wall St Ste 100 Norman OK 73069-6360 Ph: (405) 579-7560 | Norman Behavioral Health Group, Llc 712 Wall St Ste 100 Norman OK 73069-6360 Ph: (405) 579-7560 |
| NPI Number | 1194714972 |
|---|---|
| Provider Enumeration Date | 10/14/2005 |
| Last Update Date | 11/09/2023 |
| Certification Date | 11/09/2023 |
| Medicare PECOS PAC ID | 3173521341 |
|---|---|
| Medicare Enrollment ID | O20061122000251 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194714972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Robert M Martin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699764225 PECOS PAC ID: 9032117296 Enrollment ID: I20061122000204 |
| Provider Name | Alan W Ivy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316134380 PECOS PAC ID: 5991884215 Enrollment ID: I20080512000168 |
| Provider Name | Taylor English |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376288985 PECOS PAC ID: 9335507060 Enrollment ID: I20230628000120 |
| Provider Name | Lois Sydonie Goodgame |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215940267 PECOS PAC ID: 5991158735 Enrollment ID: I20240129003213 |
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