Provider Demographics
NPI:1386080307
Name:PARTON, NISHA (LADC/MH CANDIDATE)
Entity type:Individual
Prefix:
First Name:NISHA
Middle Name:
Last Name:PARTON
Suffix:
Gender:
Credentials:LADC/MH CANDIDATE
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 10
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-0010
Mailing Address - Country:US
Mailing Address - Phone:405-265-7110
Mailing Address - Fax:405-265-2553
Practice Address - Street 1:110 S 5TH ST STE 200
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-2658
Practice Address - Country:US
Practice Address - Phone:405-265-7110
Practice Address - Fax:405-265-2553
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor