| Gaybra Schultz, Lcsw, Pllc | |
|
5705 Nw 132nd St Oklahoma City OK 73142-4437 | |
| (405) 626-7853 | |
| (405) 607-1339 |
| Full Name | Gaybra Schultz, Lcsw, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5705 Nw 132nd St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Gaybra L Schultz (PRESIDENT) |
| Authorized Official Contact | 4056267853 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gaybra Schultz, Lcsw, Pllc 5705 Nw 132nd St Oklahoma City OK 73142-4437 Ph: (405) 626-7853 | Gaybra Schultz, Lcsw, Pllc 5705 Nw 132nd St Oklahoma City OK 73142-4437 Ph: (405) 626-7853 |
| NPI Number | 1407421324 |
|---|---|
| Provider Enumeration Date | 05/24/2021 |
| Last Update Date | 05/24/2021 |
| Certification Date | 05/24/2021 |
| Medicare PECOS PAC ID | 6507265394 |
|---|---|
| Medicare Enrollment ID | O20210527001844 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407421324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Gaybra L Schultz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144562471 PECOS PAC ID: 9133367881 Enrollment ID: I20130607000565 |
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