Provider Demographics
NPI:1497088033
Name:ROWE, MARKETTA A (LPC)
Entity Type:Individual
Prefix:
First Name:MARKETTA
Middle Name:A
Last Name:ROWE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MARKETTA
Other - Middle Name:
Other - Last Name:LOVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5800 E SKELLY DR STE 1101
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-6448
Mailing Address - Country:US
Mailing Address - Phone:918-779-4556
Mailing Address - Fax:918-779-4556
Practice Address - Street 1:5525 E 51ST ST STE 400
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-7461
Practice Address - Country:US
Practice Address - Phone:918-355-6457
Practice Address - Fax:918-355-8456
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7065101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100746170GMedicaid