Healthcare Provider Details

I. General information

NPI: 1336243427
Provider Name (Legal Business Name): STUART L HOLDERNESS PHD LPC LMFT CADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7151 SOUTH BRADEN AVE DR STUART HOLDERNESS & ASSOCIATES
TULSA OK
74136
US

IV. Provider business mailing address

7151 SOUTH BRADEN AVE DR STUART HOLDERNESS & ASSOCIATES
TULSA OK
74136
US

V. Phone/Fax

Practice location:
  • Phone: 918-499-0300
  • Fax: 918-499-0357
Mailing address:
  • Phone: 918-499-0300
  • Fax: 918-499-0357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number579
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number317
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1087
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: