Provider Demographics
NPI:1902426976
Name:PATRA, CHLOE BELLA (MA, LADC/MH)
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:BELLA
Last Name:PATRA
Suffix:
Gender:
Credentials:MA, LADC/MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 N MACARTHUR BLVD APT 1005
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-3046
Mailing Address - Country:US
Mailing Address - Phone:405-569-8857
Mailing Address - Fax:
Practice Address - Street 1:12301 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-3037
Practice Address - Country:US
Practice Address - Phone:405-569-8857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1476101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)