Healthcare Provider Details

I. General information

NPI: 1699090571
Provider Name (Legal Business Name): VICKI LYNNE ESTES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2010
Last Update Date: 04/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 N GREENWOOD AVE STE 302
TULSA OK
74120-1446
US

IV. Provider business mailing address

130 N GREENWOOD AVE STE 302
TULSA OK
74120-1446
US

V. Phone/Fax

Practice location:
  • Phone: 918-599-7277
  • Fax: 918-599-7716
Mailing address:
  • Phone: 918-599-7277
  • Fax: 918-599-7716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4064
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: