Healthcare Provider Details

I. General information

NPI: 1164251047
Provider Name (Legal Business Name): CHLOE ROBY LPC-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 S MUSTANG RD STE B
YUKON OK
73099-7314
US

IV. Provider business mailing address

416 S MUSTANG RD STE B
YUKON OK
73099-7314
US

V. Phone/Fax

Practice location:
  • Phone: 405-445-4489
  • Fax:
Mailing address:
  • Phone: 405-445-4489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12288
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: