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General NPI Number Information
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NPI Number | 1568941243
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Entity Type | Individual
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Provider Name | MOLLY SUZANNE HEDGEPETH LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 5310 E 31ST ST
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City | TULSA
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State | OK
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Zip | 74135-5018
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Country | US
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Telephone | 918-587-9471
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Fax |
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Provider Business Mailing Address
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Address Line | 1932 E 133RD CT
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City | BIXBY
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State | OK
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Zip | 74008-1049
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Country | US
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Telephone | 918-813-2036
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Fax |
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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 | 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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