Healthcare Provider Details

I. General information

NPI: 1972906402
Provider Name (Legal Business Name): ERICA VIOLETT MA, PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ERICA THUESON

II. Dates (important events)

Enumeration Date: 09/29/2014
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6440 S LEWIS AVE STE 2200
TULSA OK
74136-1060
US

IV. Provider business mailing address

2885 W BATTLEFIELD ST
SPRINGFIELD MO
65807-3952
US

V. Phone/Fax

Practice location:
  • Phone: 918-712-0859
  • Fax: 918-388-6456
Mailing address:
  • Phone: 417-761-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12615
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12615
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: