Healthcare Provider Details
I. General information
NPI: 1366249633
Provider Name (Legal Business Name): ALL I CAN BE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/25/2025
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13720 E 86TH ST N STE 170
OWASSO OK
74055-8741
US
IV. Provider business mailing address
25625 BRIAR DR
CLAREMORE OK
74019-4512
US
V. Phone/Fax
- Phone: 918-516-8128
- Fax: 539-399-7548
- Phone: 918-516-8128
- Fax: 539-399-7548
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
BRITTANY
LAYNE
GAROUTTE
Title or Position: OWNER
Credential: LPC
Phone: 918-516-8128