MEDICARE: CLEMENTINE OKLAHOMA ABA LLC

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1417805532
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEMENTINE OKLAHOMA ABA LLC

Provider Business Mailing Address
First Line	:	5600 N MAY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-3973
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5600 N MAY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-3973
Country	:	US
Telephone Number	:	888-603-2536
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	AHARON GERSON
Credential	:
Telephone Number	:	516-510-5074

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

Similar Medicare Providers

1538391214 — MAYFLOWER ORAL AND MAXILLOFACIAL SURGERY PLLC
Practice Location Address:

5600 N MAY AVE , SUITE 250
OKLAHOMA CITY, OK
73112-3973

Practice Phone: 405-848-7974
Practice Fax: 405-848-0033

1437381753 — TAHOE ORAL AND MAXILLOFACIAL SURGERY
Practice Location Address:

5600 N MAY AVE , SUITE 250
OKLAHOMA CITY, OK
73112-3973

Practice Phone: 405-848-7974
Practice Fax: 405-848-0033

1447561741 — INNOVATIVE SENIOR CARE HOME HEALTH OF EDMOND LLC
Practice Location Address:

5600 N MAY AVE , STE 147
OKLAHOMA CITY, OK
73112-3973

Practice Phone: 405-341-4361
Practice Fax: 405-341-4349

1720338932 — INTERIM HEALTHCARE OF OKLAHOMA CITY, INC.
Practice Location Address:

5600 N MAY AVE , SUITE 145
OKLAHOMA CITY, OK
73112-3973

Practice Phone: 405-848-3555
Practice Fax: 405-842-4629

1144763590 — ADAM BOYD
Practice Location Address:

5600 N MAY AVE , 147
OKLAHOMA CITY, OK
73112-3973

Practice Phone: 405-341-4361
Practice Fax:

1891470852 — LINDSEY SHEPARDSON OTR/L
Practice Location Address:

5600 N MAY AVE
OKLAHOMA CITY, OK
73112-3973

Practice Phone: 405-341-4361
Practice Fax:

Directions to “CLEMENTINE OKLAHOMA ABA LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.