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General NPI Number Information
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NPI Number | 1285159343
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Entity Type | Individual
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Provider Name | KEELA LEIGH WORMAN LPC
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Gender | Female
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Dates
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Enumeration Date | 08/10/2017
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 65741 N 2370 RD
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City | CANTON
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State | OK
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Zip | 73724-1232
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Country | US
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Telephone | 580-884-0098
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Fax | 580-237-7550
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Provider Business Mailing Address
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Address Line | 65741 N 2370 RD
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City | CANTON
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State | OK
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Zip | 73724-1232
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Country | US
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Telephone | 580-884-0098
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Fax | 580-237-7550
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7280
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC07280
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License Number State | OK
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