Healthcare Provider Details

I. General information

NPI: 1437558277
Provider Name (Legal Business Name): NICOLE RENE HOLZKAMPER MA, LPC- CANDIDATE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2014
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 S PEORIA AVE
TULSA OK
74120-3820
US

IV. Provider business mailing address

2325 S HARVARD AVE
TULSA OK
74114-3300
US

V. Phone/Fax

Practice location:
  • Phone: 918-588-1900
  • Fax: 918-382-1285
Mailing address:
  • Phone: 918-712-4301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10762
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: