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NPI Code Detail

MEDICARE: DR. MARY SUSAN MCAULIFF EDD, LPC

MEDICARE: DR. MARY SUSAN MCAULIFF EDD, LPC
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1073380499
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY SUSAN MCAULIFF EDD, LPC
Provider Business Mailing Address
First Line : 33914 E 714 RD
Second Line :
City : WAGONER
State : OK
Zip : 74467-8485
Country : US
Telephone Number : 406-548-5552
Fax Number :
Provider Business Practice Location Address
First Line : 4103 S YALE AVE STE B
Second Line :
City : TULSA
State : OK
Zip : 74135-6002
Country : US
Telephone Number : 918-382-7300
Fax Number : 918-382-7302
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2023
Last Update Date : 01/17/2026

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