Healthcare Provider Details
I. General information
NPI: 1124373584
Provider Name (Legal Business Name): JODY MUELLER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/20/2012
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2114 SE WASHINGTON BLVD
BARTLESVILLE OK
74006-7254
US
IV. Provider business mailing address
640 NE BISON RD
BARTLESVILLE OK
74006-8075
US
V. Phone/Fax
- Phone: 918-876-4211
- Fax: 918-876-4215
- Phone: 918-331-5140
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 06525 |
| License Number State | OK |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 2022004940 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: