| Kellie Sperry Lpc Pllc | |
|
4201 W Memorial Rd Apt 8108 Oklahoma City OK 73134-1766 | |
| (405) 255-5982 | |
| Not Available |
| Full Name | Kellie Sperry Lpc Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4201 W Memorial Rd Apt 8108, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Kellie Sperry (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 4052555982 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kellie Sperry Lpc Pllc 4201 W Memorial Rd Apt 8108 Oklahoma City OK 73134-1766 Ph: (405) 255-5982 | Kellie Sperry Lpc Pllc 4201 W Memorial Rd Apt 8108 Oklahoma City OK 73134-1766 Ph: (405) 255-5982 |
| NPI Number | 1568110542 |
|---|---|
| Provider Enumeration Date | 03/17/2022 |
| Last Update Date | 04/08/2022 |
| Certification Date | 04/08/2022 |
| Medicare PECOS PAC ID | 3577916386 |
|---|---|
| Medicare Enrollment ID | O20240129001875 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568110542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Kellie Sperry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427293026 PECOS PAC ID: 4486007291 Enrollment ID: I20240129002700 |
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