Healthcare Provider Details

I. General information

NPI: 1942667605
Provider Name (Legal Business Name): LEANA LEDBETTER LPC-C
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 10/21/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 S WALKER AVE
OKLAHOMA CITY OK
73139-7026
US

IV. Provider business mailing address

6100 S WALKER AVE
OKLAHOMA CITY OK
73139-7026
US

V. Phone/Fax

Practice location:
  • Phone: 405-634-4400
  • Fax:
Mailing address:
  • Phone: 405-634-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT20137061
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: