Provider Demographics
NPI:1912578121
Name:HOLLOPETER, CAITLIN LEE (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:LEE
Last Name:HOLLOPETER
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21801 E 104TH ST S
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-4314
Mailing Address - Country:US
Mailing Address - Phone:918-636-7375
Mailing Address - Fax:
Practice Address - Street 1:9717 E 42ND ST STE 201
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-3680
Practice Address - Country:US
Practice Address - Phone:918-270-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10015101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health