Healthcare Provider Details

I. General information

NPI: 1124956578
Provider Name (Legal Business Name): I MPOSSIBLE THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7338 E 92ND ST
TULSA OK
74133-6039
US

IV. Provider business mailing address

7338 E 92ND ST
TULSA OK
74133-6039
US

V. Phone/Fax

Practice location:
  • Phone: 539-260-0749
  • Fax:
Mailing address:
  • Phone: 539-260-0749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: HAYLEY YORK WOOD
Title or Position: SOLE MEMBER/OWNER
Credential: LPC
Phone: 539-260-0749