Provider Demographics
NPI:1780904110
Name:LENTS, ROSS (LPC)
Entity type:Individual
Prefix:MR
First Name:ROSS
Middle Name:
Last Name:LENTS
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 1:2301 W I 44 SERVICE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-8766
Mailing Address - Country:US
Mailing Address - Phone:405-471-2211
Mailing Address - Fax:405-286-6396
Practice Address - Street 1:2301 W I 44 SERVICE RD STE 300
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8766
Practice Address - Country:US
Practice Address - Phone:405-471-2211
Practice Address - Fax:405-286-6396
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4729101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100728800CMedicaid