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NPI Code Detail

MEDICARE: LATIA R PARKER LADC, LPC

MEDICARE: LATIA R PARKER LADC, 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
1101YA0400XAddiction (Substance Use Disorder) Counselor659OK
2101YP2500XProfessional Counselor3343OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164669149
Entity Type Code : Individual
Provider Name (Legal Business Name) : LATIA R PARKER LADC, LPC
Provider Business Mailing Address
First Line : 200 W HOBSON AVE
Second Line :
City : SAPULPA
State : OK
Zip : 74066-3926
Country : US
Telephone Number : 918-902-5348
Fax Number : 918-340-5189
Provider Business Practice Location Address
First Line : 2508 E 71ST ST
Second Line : SUITE C
City : TULSA
State : OK
Zip : 74136-5572
Country : US
Telephone Number : 918-794-6570
Fax Number : 918-340-5189
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2009
Last Update Date : 06/04/2026

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