Provider Demographics
NPI:1780568907
Name:THERAPY AT THIRD, LLC
Entity type:Organization
Organization Name:THERAPY AT THIRD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ODRIKUS
Authorized Official - Middle Name:D
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:918-971-8964
Mailing Address - Street 1:2325 S HARVARD AVE FL 6
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-3303
Mailing Address - Country:US
Mailing Address - Phone:918-971-8964
Mailing Address - Fax:
Practice Address - Street 1:2325 S HARVARD AVE FL 6
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-3303
Practice Address - Country:US
Practice Address - Phone:918-971-8964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty