MEDICARE: I MPOSSIBLE THERAPY SERVICES LLC

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

General Provider Information

NPI Number	:	1124956578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	I MPOSSIBLE THERAPY SERVICES LLC

Provider Business Mailing Address
First Line	:	7338 E 92ND ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-6039
Country	:	US
Telephone Number	:	539-260-0749
Fax Number	:

Provider Business Practice Location Address
First Line	:	7338 E 92ND ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-6039
Country	:	US
Telephone Number	:	539-260-0749
Fax Number	:

Authorized Official
Title or Position	:	SOLE MEMBER/OWNER
Name	:	HAYLEY YORK WOOD
Credential	:	LPC
Telephone Number	:	539-260-0749

Provider Enumeration Date	:	05/13/2026
Last Update Date	:	05/13/2026

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