Healthcare Provider Details

I. General information

NPI: 1336917996
Provider Name (Legal Business Name): DEREK LEE STEVENS LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 24TH AVE SW
NORMAN OK
73069-5106
US

IV. Provider business mailing address

3020 RED CEDAR WAY
NORMAN OK
73069-1329
US

V. Phone/Fax

Practice location:
  • Phone: 405-329-7923
  • Fax: 405-329-8815
Mailing address:
  • Phone: 405-443-7619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number11124
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: