Healthcare Provider Details

I. General information

NPI: 1861706921
Provider Name (Legal Business Name): JANICE BEATRICE WATKINS ED.D., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2010
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4870 SOUTH LEWIS AVENUE, STE 190
TULSA OK
74105
US

IV. Provider business mailing address

4870 SOUTH LEWIS AVENUE, STE 190
TULSA OK
74105
US

V. Phone/Fax

Practice location:
  • Phone: 918-404-5357
  • Fax: 918-742-7677
Mailing address:
  • Phone: 918-404-5357
  • Fax: 918-742-7677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number551
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number551
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: