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NPI Code Detail

MEDICARE: LAURIE JANE CHAMBLISS LADC-S

MEDICARE: LAURIE JANE CHAMBLISS LADC-S
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) Counselor

General Provider Information

NPI Number : 1548698160
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURIE JANE CHAMBLISS LADC-S
Provider Business Mailing Address
First Line : 4845 S SHERIDAN RD STE 510
Second Line :
City : TULSA
State : OK
Zip : 74145-5719
Country : US
Telephone Number : 918-384-0002
Fax Number : 918-384-0004
Provider Business Practice Location Address
First Line : 4845 S SHERIDAN RD
Second Line : SUITE 510
City : TULSA
State : OK
Zip : 74145-5751
Country : US
Telephone Number : 918-384-0002
Fax Number : 918-384-0004
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2013
Last Update Date : 04/02/2026

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Directions to “ LAURIE JANE CHAMBLISS LADC-S” Practice Location

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