Healthcare Provider Details

I. General information

NPI: 1043149057
Provider Name (Legal Business Name): MRS. KAYLEY SCHUBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7623 E 126TH STREET SUITE A
BIXBY OK
74008
US

IV. Provider business mailing address

1669 S PINE AVE
BROKEN ARROW OK
74012-5235
US

V. Phone/Fax

Practice location:
  • Phone: 918-609-4902
  • Fax: 539-250-4120
Mailing address:
  • Phone: 918-609-4902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: