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NPI Code Detail

MEDICARE: JENNIFIER LYNN PRICE LPC, LADC

MEDICARE: JENNIFIER LYNN PRICE LPC, LADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor788OK
2101YM0800XMental Health Counselor3233OK

General Provider Information

NPI Number : 1417083544
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFIER LYNN PRICE LPC, LADC
Provider Business Mailing Address
First Line : 2202 E 49TH ST STE 400
Second Line :
City : TULSA
State : OK
Zip : 74105-8714
Country : US
Telephone Number : 918-749-1840
Fax Number :
Provider Business Practice Location Address
First Line : 2202 E 49TH ST STE 400
Second Line :
City : TULSA
State : OK
Zip : 74105-8714
Country : US
Telephone Number : 918-749-1840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2007
Last Update Date : 08/04/2024

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Directions to “ JENNIFIER LYNN PRICE LPC, LADC” Practice Location

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