Healthcare Provider Details

I. General information

NPI: 1407017452
Provider Name (Legal Business Name): BRIANA NICHOLE SCHULZ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRIANA NICHOLE WENSEL LPC

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 NORTH D STREET
MCALESTER OK
74501-2314
US

IV. Provider business mailing address

1602 NORTH D STREET
MCALESTER OK
74501-2314
US

V. Phone/Fax

Practice location:
  • Phone: 918-426-1614
  • Fax: 918-426-1648
Mailing address:
  • Phone: 918-426-1614
  • Fax: 918-426-1648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC06218
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: