Provider Demographics
NPI:1275964165
Name:GLOVER, KATHY S (MS, LPC)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:S
Last Name:GLOVER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 H ST SE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:OK
Mailing Address - Zip Code:74354-7908
Mailing Address - Country:US
Mailing Address - Phone:918-387-8720
Mailing Address - Fax:866-792-2281
Practice Address - Street 1:615 H ST SE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-7908
Practice Address - Country:US
Practice Address - Phone:918-387-8720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-03
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health