Provider Demographics
NPI:1295958387
Name:VIVES, ALLAN P (PHD)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:P
Last Name:VIVES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 SADDLE LN
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-5745
Mailing Address - Country:US
Mailing Address - Phone:918-387-8428
Mailing Address - Fax:918-309-2944
Practice Address - Street 1:1501 SADDLE LN
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-5745
Practice Address - Country:US
Practice Address - Phone:918-387-8428
Practice Address - Fax:918-309-2944
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002716103TC0700X
OK1488103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA171420005AMedicaid
GA171420005AMedicaid