Healthcare Provider Details

I. General information

NPI: 1376246306
Provider Name (Legal Business Name): BRICKHOUSE THERAPY SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 N BROADWAY ST
TECUMSEH OK
74873-2020
US

IV. Provider business mailing address

602 N BROADWAY ST
TECUMSEH OK
74873-2020
US

V. Phone/Fax

Practice location:
  • Phone: 405-481-0447
  • Fax:
Mailing address:
  • Phone: 405-481-0447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHAYA LEIGH HARRIS
Title or Position: LCSW
Credential: LCSW
Phone: 405-481-0447