Healthcare Provider Details

I. General information

NPI: 1912611583
Provider Name (Legal Business Name): ASHLEY J STICHT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2023
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 S WALKER AVE
OKLAHOMA CITY OK
73139-7026
US

IV. Provider business mailing address

9516 S SHIELDS BLVD APT 158
MOORE OK
73160-3123
US

V. Phone/Fax

Practice location:
  • Phone: 405-634-4400
  • Fax:
Mailing address:
  • Phone: 860-227-9490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number22015
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: