Healthcare Provider Details

I. General information

NPI: 1972952489
Provider Name (Legal Business Name): SHERRIE LYNN CARTER-GREENE L.P. C. (CANDIDATE)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2016
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 N GREENWOOD AVE STE 305
TULSA OK
74120-1443
US

IV. Provider business mailing address

8250 CONIFER RD
HENRYETTA OK
74437-1465
US

V. Phone/Fax

Practice location:
  • Phone: 918-557-6882
  • Fax: 918-794-3636
Mailing address:
  • Phone: 918-557-6882
  • Fax: 918-794-9622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: