MEDICARE: DR. STUART L HOLDERNESS PHD LPC LMFT CADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	579	OK
2	106H00000X	Marriage & Family Therapist	317	OK
3	101YP2500X	Professional Counselor	1087	OK

General Provider Information

NPI Number	:	1336243427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STUART L HOLDERNESS PHD LPC LMFT CADC

Provider Business Mailing Address
First Line	:	7151 SOUTH BRADEN AVE
Second Line	:	DR STUART HOLDERNESS & ASSOCIATES
City	:	TULSA
State	:	OK
Zip	:	74136
Country	:	US
Telephone Number	:	918-499-0300
Fax Number	:	918-499-0357

Provider Business Practice Location Address
First Line	:	7151 SOUTH BRADEN AVE
Second Line	:	DR STUART HOLDERNESS & ASSOCIATES
City	:	TULSA
State	:	OK
Zip	:	74136
Country	:	US
Telephone Number	:	918-499-0300
Fax Number	:	918-499-0357

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

Provider Enumeration Date	:	09/11/2006
Last Update Date	:	12/02/2025

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