Individual
SAMANTHA WHELAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
11701 S QUEBEC AVE, TULSA, OK 74137-6117
(256) 520-6436
Mailing address
11701 S QUEBEC AVE, TULSA, OK 74137-6117
(256) 520-6436
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2051 LPC
AL
101Y00000X
Counselor
7275
OK
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
110 MLAP
AL
101YA0400X
Addiction (Substance Use Disorder) Counselor
2051
AL
101YM0800X
Mental Health Counselor
7275
OK
101YP2500X
Professional Counselor
Primary
7275
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51524735
FEP BCBS
AL
Enumeration date
08/03/2006
Last updated
09/16/2022
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