| Leopard Print Therapy Group Llc | |
|
2200 N Classen Blvd Ste 702 Oklahoma City OK 73106-5806 | |
| (405) 503-7930 | |
| Not Available |
| Full Name | Leopard Print Therapy Group Llc |
|---|---|
| Speciality | Counselor |
| Location | 2200 N Classen Blvd Ste 702, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Sherita Gibson (LPC) |
| Authorized Official Contact | 4055037930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leopard Print Therapy Group Llc 2200 N Classen Blvd Ste 702 Oklahoma City OK 73106-5806 Ph: (405) 503-7930 | Leopard Print Therapy Group Llc 2200 N Classen Blvd Ste 702 Oklahoma City OK 73106-5806 Ph: (405) 503-7930 |
| NPI Number | 1053059337 |
|---|---|
| Provider Enumeration Date | 05/25/2022 |
| Last Update Date | 05/25/2022 |
| Certification Date | 05/25/2022 |
| Medicare PECOS PAC ID | 7012358096 |
|---|---|
| Medicare Enrollment ID | O20240508000837 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053059337 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Sherita Dawn Gibson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558876581 PECOS PAC ID: 8921449901 Enrollment ID: I20240508000941 |
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