Provider Demographics
NPI:1396337069
Name:ELAINE DEMKE LLC
Entity type:Organization
Organization Name:ELAINE DEMKE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMKE
Authorized Official - Suffix:
Authorized Official - Credentials:MS LMFT
Authorized Official - Phone:405-604-7982
Mailing Address - Street 1:1900 NW EXPRESSWAY STE 450
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-1849
Mailing Address - Country:US
Mailing Address - Phone:405-604-7982
Mailing Address - Fax:405-849-9164
Practice Address - Street 1:1900 NW EXPRESSWAY STE 450
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-1849
Practice Address - Country:US
Practice Address - Phone:405-604-7982
Practice Address - Fax:405-849-9164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health