Healthcare Provider Details

I. General information

NPI: 1306787015
Provider Name (Legal Business Name): CHELSEA PHILLIPS LMSW, MAADC II
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S TREATY RD
MIAMI OK
74354-5327
US

IV. Provider business mailing address

111 S TREATY RD
MIAMI OK
74354-5327
US

V. Phone/Fax

Practice location:
  • Phone: 844-458-2100
  • Fax:
Mailing address:
  • Phone: 844-458-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number22629
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: