Healthcare Provider Details

I. General information

NPI: 1689904369
Provider Name (Legal Business Name): GLENNA G PIERCE-THORSTENBERG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2010
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7627 E 126TH ST S
BIXBY OK
74008-2796
US

IV. Provider business mailing address

7627 E 126TH ST S
BIXBY OK
74008-2796
US

V. Phone/Fax

Practice location:
  • Phone: 918-296-7746
  • Fax: 918-209-5476
Mailing address:
  • Phone: 918-296-7746
  • Fax: 918-209-5476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2154
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: