Individual
DR. LANNY RAY ENDICOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LMFT
Contact information
Practice address
3631 S ELM PL, BROKEN ARROW, OK 74011-1856
(918) 557-8789
Mailing address
1208 E 58TH ST, TULSA, OK 74105-8401
(918) 742-5597
(918) 742-4485
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW 296
OK
101YM0800X
Mental Health Counselor
LMFT 328
OK
Other
Enumeration date
11/01/2011
Last updated
01/10/2022
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