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NPI Code Detail

MEDICARE: CARRIE MATHERLY

MEDICARE: CARRIE MATHERLY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistLFMTCANDIDATE13420OK

General Provider Information

NPI Number : 1063347821
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE MATHERLY
Provider Business Mailing Address
First Line : 609 SW 113TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73170-5813
Country : US
Telephone Number : 405-620-3153
Fax Number :
Provider Business Practice Location Address
First Line : 2212 WESTPARK DR
Second Line :
City : NORMAN
State : OK
Zip : 73069-4097
Country : US
Telephone Number : 405-857-7624
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2026
Last Update Date : 06/15/2026

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Directions to “ CARRIE MATHERLY ” Practice Location

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