Provider Demographics
NPI:1659141000
Name:TAMARA STONEBARGER COUNSELING
Entity Type:Organization
Organization Name:TAMARA STONEBARGER COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:STONEBARGER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:703-577-4829
Mailing Address - Street 1:1513 NW 126TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-5088
Mailing Address - Country:US
Mailing Address - Phone:703-577-4829
Mailing Address - Fax:
Practice Address - Street 1:428 S MUSTANG RD
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-6946
Practice Address - Country:US
Practice Address - Phone:703-577-4829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)