MEDICARE: STEVEN G TERRY MSW, LCSW, LMFT

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	1041C0700X	Clinical Social Worker	0139	OK
2	106H00000X	Marriage & Family Therapist	141	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4221760	OTHER	OK	AETNA PIN
2	513485291001	OTHER	OK	BCBS BILLING NUMBER

General Provider Information

NPI Number	:	1174573836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN G TERRY MSW, LCSW, LMFT

Provider Business Mailing Address
First Line	:	3223 E 31ST ST
Second Line	:	SUITE 204
City	:	TULSA
State	:	OK
Zip	:	74105-2452
Country	:	US
Telephone Number	:	918-392-0336
Fax Number	:	918-392-0337

Provider Business Practice Location Address
First Line	:	3223 E 31ST STREET
Second Line	:	SUITE 204
City	:	TULSA
State	:	OK
Zip	:	74105-2452
Country	:	US
Telephone Number	:	918-392-0336
Fax Number	:	918-392-0337

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	09/11/2025

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