Healthcare Provider Details

I. General information

NPI: 1770073389
Provider Name (Legal Business Name): ALICIA MARIE FOLMAR LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICIA MARIE JARVIS LMFT-S

II. Dates (important events)

Enumeration Date: 05/18/2018
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12617 S MCLOUD RD
MCLOUD OK
74851-8509
US

IV. Provider business mailing address

11589 CAREFREE LN
SHAWNEE OK
74804-7003
US

V. Phone/Fax

Practice location:
  • Phone: 405-441-7558
  • Fax:
Mailing address:
  • Phone: 405-226-7688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number10574
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: