MEDICARE: MRS. DEBORAH C FEDDER LPC 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	101YP2500X	Professional Counselor	2802	OK
2	106H00000X	Marriage & Family Therapist	777	OK

General Provider Information

NPI Number	:	1295803815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH C FEDDER LPC LMFT

Provider Business Mailing Address
First Line	:	11212 N MAY AVE
Second Line	:	STE 203
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-6335
Country	:	US
Telephone Number	:	405-641-2373
Fax Number	:	405-751-6525

Provider Business Practice Location Address
First Line	:	11212 N MAY AVE
Second Line	:	STE 203
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-6335
Country	:	US
Telephone Number	:	405-641-2373
Fax Number	:	405-751-6525

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

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	09/11/2025

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