Healthcare Provider Details

I. General information

NPI: 1265923577
Provider Name (Legal Business Name): LINDSEY ABIGAIL BOEHNING LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY ABIGAIL STASTNY

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1916 E 13TH ST
TULSA OK
74104-4422
US

IV. Provider business mailing address

1916 E 13TH ST
TULSA OK
74104-4422
US

V. Phone/Fax

Practice location:
  • Phone: 918-625-9661
  • Fax:
Mailing address:
  • Phone: 918-625-9661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9046
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: