Healthcare Provider Details

I. General information

NPI: 1346518255
Provider Name (Legal Business Name): DEBBIE L. WARDWORTH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2011
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8408 WILLOW VIEW DR
SPENCER OK
73084-3855
US

IV. Provider business mailing address

8408 WILLOW VIEW DR
SPENCER OK
73084-3855
US

V. Phone/Fax

Practice location:
  • Phone: 405-343-1734
  • Fax: 405-665-6396
Mailing address:
  • Phone: 405-343-1734
  • Fax: 405-665-6396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number07636
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: