Provider Demographics
NPI:1548970304
Name:HAGER, TIMOTHY (LPC)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:
Last Name:HAGER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2624 E 22ND PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-3131
Mailing Address - Country:US
Mailing Address - Phone:918-760-1098
Mailing Address - Fax:
Practice Address - Street 1:19320 E ADMIRAL PL STE B
Practice Address - Street 2:
Practice Address - City:CATOOSA
Practice Address - State:OK
Practice Address - Zip Code:74015-3240
Practice Address - Country:US
Practice Address - Phone:918-340-5503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health