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NPI Code Detail

MEDICARE: MRS. JENNIFER ELAINE WILBURN MS LPC LADC

MEDICARE: MRS. JENNIFER ELAINE WILBURN MS 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) Counselor495OK
2101YP2500XProfessional Counselor3344OK

General Provider Information

NPI Number : 1801019955
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER ELAINE WILBURN MS LPC LADC
Provider Business Mailing Address
First Line : 4845 S SHERIDAN RD
Second Line : SUITE 510
City : TULSA
State : OK
Zip : 74145-5751
Country : US
Telephone Number : 918-384-0002
Fax Number : 918-384-0004
Provider Business Practice Location Address
First Line : 4845 S SHERIDAN RD
Second Line : SUITE 510
City : TULSA
State : OK
Zip : 74145-5751
Country : US
Telephone Number : 918-384-0002
Fax Number : 918-384-0004
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 09/11/2025

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