Provider Demographics
NPI:1871702258
Name:BYRD, CHRISTY DIANE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:DIANE
Last Name:BYRD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 196
Mailing Address - Street 2:
Mailing Address - City:NOBLE
Mailing Address - State:OK
Mailing Address - Zip Code:73068-0196
Mailing Address - Country:US
Mailing Address - Phone:405-568-2003
Mailing Address - Fax:405-872-8466
Practice Address - Street 1:115 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NOBLE
Practice Address - State:OK
Practice Address - Zip Code:73068
Practice Address - Country:US
Practice Address - Phone:405-568-2003
Practice Address - Fax:405-872-8466
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK928106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200260590BMedicaid