Healthcare Provider Details

I. General information

NPI: 1871562108
Provider Name (Legal Business Name): JERRY ALLAN GATES LPC, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6655 S YALE AVE LAUREATE PSYCHIATRIC CLINIC AND HOSPITAL
TULSA OK
74136-3326
US

IV. Provider business mailing address

6655 S YALE AVE LAUREATE PSYCHIATRIC CLINIC AND HOSPITAL
TULSA OK
74136-3326
US

V. Phone/Fax

Practice location:
  • Phone: 918-481-4000
  • Fax: 918-491-5740
Mailing address:
  • Phone: 918-481-4000
  • Fax: 918-491-5740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number313
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number307
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: