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General NPI Number Information
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NPI Number | 1760349054
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Entity Type | Individual
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Provider Name | PHYLLIS WOOLSEY LMFTCAND
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Gender | Female
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 2510 CHICKASAW BLVD
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City | ARDMORE
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State | OK
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Zip | 73401-1341
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Country | US
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Telephone | 580-222-2884
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Fax | 580-272-5757
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Provider Business Mailing Address
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Address Line | 124 E MAIN ST STE B4
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City | ADA
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State | OK
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Zip | 74820-5623
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Country | US
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Telephone | 580-436-7206
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Fax | 580-272-5757
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 13146
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License Number State | OK
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