Healthcare Provider Details

I. General information

NPI: 1245564251
Provider Name (Legal Business Name): SHERI ROBERTSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2009
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395200 W 2900 RD
OCHELATA OK
74051-2463
US

IV. Provider business mailing address

115 KAISER WAY
DEWEY OK
74029-3029
US

V. Phone/Fax

Practice location:
  • Phone: 918-535-6053
  • Fax:
Mailing address:
  • Phone: 918-213-9899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1035
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: