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Individual

MR. DERRICK LAMONT WOODBURY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
10212 E 41ST ST, TULSA, OK 74146-3703
(918) 970-0028
(918) 960-7308
Mailing address
5928 E 7TH ST, TULSA, OK 74112-2913
(918) 970-0028
(918) 960-7308

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5604
OK
101YP2500X
Professional Counselor
5604
OK
101YP2500X
Professional Counselor
LPC013870
GA
101YP2500X
Professional Counselor
P2212014
AR

Other

Enumeration date
05/15/2015
Last updated
03/10/2026
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