Provider Demographics
NPI:1891379848
Name:ESTRADA LUJAN, ANA TERESA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:TERESA
Last Name:ESTRADA LUJAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 N GREENWOOD AVE STE 131
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120-1444
Mailing Address - Country:US
Mailing Address - Phone:918-599-7277
Mailing Address - Fax:
Practice Address - Street 1:101 N GREENWOOD AVE STE 131
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-1444
Practice Address - Country:US
Practice Address - Phone:918-599-7277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 104100000X
OK74801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker