MEDICARE: KODY GARIS 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
1	101Y00000X	Counselor
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1417729567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KODY GARIS LPC

Provider Business Mailing Address
First Line	:	6475 36TH AVE NW APT 1137
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73072-1350
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	102 W EUFAULA ST STE 113
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73069-5688
Country	:	US
Telephone Number	:	405-881-5337
Fax Number	:

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

Provider Enumeration Date	:	10/23/2023
Last Update Date	:	06/16/2026

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Directions to “ KODY GARIS LPC” Practice Location

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