Healthcare Provider Details

I. General information

NPI: 1326103086
Provider Name (Legal Business Name): JUDITH KAREN ADAMS PH.D., LMFT, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2006
Last Update Date: 07/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9726 E. 42ND STREET SO. SUITE 106
TULSA OK
74146-3673
US

IV. Provider business mailing address

9726 E. 42ND STREET SO. SUITE 106
TULSA OK
74146-3673
US

V. Phone/Fax

Practice location:
  • Phone: 918-712-7711
  • Fax: 918-712-8865
Mailing address:
  • Phone: 918-712-7711
  • Fax: 918-712-8865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number388
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number206
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number133
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: