MEDICARE: CORE 6 THERAPEUTIC SERVICES

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1104764067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE 6 THERAPEUTIC SERVICES

Provider Business Mailing Address
First Line	:	9919 W 57TH ST
Second Line	:
City	:	SAND SPRINGS
State	:	OK
Zip	:	74063-4724
Country	:	US
Telephone Number	:	405-562-0308
Fax Number	:

Provider Business Practice Location Address
First Line	:	9919 W 57TH ST
Second Line	:
City	:	SAND SPRINGS
State	:	OK
Zip	:	74063-4724
Country	:	US
Telephone Number	:	405-562-0308
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	CASEY FIELDS
Credential	:	LCSW
Telephone Number	:	405-562-0308

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	05/19/2026

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