Healthcare Provider Details

I. General information

NPI: 1760165237
Provider Name (Legal Business Name): SHIELA WOOTEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHIELA LINDSEY

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4103 S YALE AVE STE B
TULSA OK
74135-6002
US

IV. Provider business mailing address

4103 S YALE AVE STE B
TULSA OK
74135-6002
US

V. Phone/Fax

Practice location:
  • Phone: 918-382-7300
  • Fax: 918-382-7302
Mailing address:
  • Phone: 918-382-7300
  • Fax: 918-382-7302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: