MEDICARE: ERIC L. CLEMENTS

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	101YP2500X	Professional Counselor	1673	OK
2	106H00000X	Marriage & Family Therapist	758	OK

General Provider Information

NPI Number	:	1114088895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC L. CLEMENTS

Provider Business Mailing Address
First Line	:	6846 S CANTON AVE
Second Line	:	SUITE 501
City	:	TULSA
State	:	OK
Zip	:	74136-3412
Country	:	US
Telephone Number	:	918-745-0095
Fax Number	:	918-745-0190

Provider Business Practice Location Address
First Line	:	6846 S CANTON AVE
Second Line	:	SUITE 501
City	:	TULSA
State	:	OK
Zip	:	74136-3412
Country	:	US
Telephone Number	:	918-745-0095
Fax Number	:	918-745-0190

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	05/10/2011

Similar Medicare Providers

1003700444 — EMILY MARISSA WALLACE
Practice Location Address:

6846 S CANTON AVE
TULSA, OK
74136-3412

Practice Phone: 918-806-0106
Practice Fax:

1053771758 — KIMBERLY WADE M.S., CCC-SLP
Practice Location Address:

6846 S CANTON AVE STE 120
TULSA, OK
74136-3412

Practice Phone: 918-441-8554
Practice Fax:

1730148222 — KRISTA E. CAVENY LPC
Practice Location Address:

6846 S CANTON AVE , #501
TULSA, OK
74136-3412

Practice Phone: 918-745-0095
Practice Fax: 918-745-0190

1013922889 — CHRISTIAN FAMILY INSTITUTE INC
Practice Location Address:

6846 S CANTON AVE , SUITE 501
TULSA, OK
74136-3412

Practice Phone: 918-745-0095
Practice Fax: 918-745-0190

1558497248 — LOIS K. TROST M.S.W.
Practice Location Address:

6846 S CANTON AVE , SUITE 501
TULSA, OK
74136-3412

Practice Phone: 918-745-0095
Practice Fax: 918-745-0190

1548390420 — HOLLY SIMPSON LPC
Practice Location Address:

6846 S CANTON AVE
TULSA, OK
74136-3412

Practice Phone: 918-795-0095
Practice Fax: 918-795-0190

Directions to “ ERIC L. CLEMENTS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.