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General NPI Number Information
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NPI Number | 1437822335
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Entity Type | Organization
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Legal Business Name | LOURDES COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 07/27/2021
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Last Update Date | 08/23/2021
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Provider Practice Location Address
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Address Line | 5200 S YALE AVE STE 203
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City | TULSA
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State | OK
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Zip | 74135-7486
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Country | US
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Telephone | 918-955-0335
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Fax |
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Provider Business Mailing Address
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Address Line | 3607 S FLORENCE AVE
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City | TULSA
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State | OK
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Zip | 74105-3622
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Country | US
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Telephone | 918-955-0335
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | ASHLEY K HEATHERMAN
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Credential | LCSW
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Telephone | 918-955-0335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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