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NPI Code Detail

MEDICARE: MS. JACKIE JEAN LINDBLAD-LANDLER LPC LADC

MEDICARE:  MS. JACKIE JEAN LINDBLAD-LANDLER  LPC LADC
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) Counselor282OK
2101YP2500XProfessional Counselor2634OK

General Provider Information

NPI Number : 1356476667
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JACKIE JEAN LINDBLAD-LANDLER LPC LADC
Provider Business Mailing Address
First Line : 5228 CLASSEN CIRCLE
Second Line : A CHANCE TO CHANGE
City : OKLAHOMA CITY
State : OK
Zip : 73118
Country : US
Telephone Number : 405-840-9000
Fax Number : 405-840-9017
Provider Business Practice Location Address
First Line : 5228 CLASSEN CIRCLE
Second Line : A CHANCE TO CHANGE
City : OKLAHOMA CITY
State : OK
Zip : 73118
Country : US
Telephone Number : 405-840-9000
Fax Number : 405-840-9017
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 09/11/2025

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Directions to “ MS. JACKIE JEAN LINDBLAD-LANDLER LPC LADC” Practice Location

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