Healthcare Provider Details

I. General information

NPI: 1508949421
Provider Name (Legal Business Name): STEVEN ELSMERE CHAMBERLIN L.P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 E 15TH ST
TULSA OK
74104-4608
US

IV. Provider business mailing address

1715 S INDIANAPOLIS AVE
TULSA OK
74112-5831
US

V. Phone/Fax

Practice location:
  • Phone: 918-743-0288
  • Fax: 918-747-6151
Mailing address:
  • Phone: 918-747-3672
  • Fax: 918-747-6151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number285
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number285
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: