Provider Demographics
NPI:1003688623
Name:CRIBBS, CHARLOTTE L (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:L
Last Name:CRIBBS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CARLY
Other - Middle Name:LEE
Other - Last Name:CRIBBS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5020 E 97TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-4902
Mailing Address - Country:US
Mailing Address - Phone:918-606-1408
Mailing Address - Fax:
Practice Address - Street 1:650 S PEORIA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-4429
Practice Address - Country:US
Practice Address - Phone:918-587-9471
Practice Address - Fax:918-560-1399
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20421-P1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical