Provider Demographics
NPI:1144532441
Name:ATAKPO, SYLVESTER EDET (MHR, LADC CANDIDATE)
Entity type:Individual
Prefix:MR
First Name:SYLVESTER
Middle Name:EDET
Last Name:ATAKPO
Suffix:
Gender:M
Credentials:MHR, LADC CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 WESTMORE DR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73170-7469
Mailing Address - Country:US
Mailing Address - Phone:405-227-1320
Mailing Address - Fax:
Practice Address - Street 1:6803 S WESTERN AVE
Practice Address - Street 2:STE. 309
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-1808
Practice Address - Country:US
Practice Address - Phone:405-604-5344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-02
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)