Provider Demographics
NPI:1922175850
Name:GILBERT, LAWRENCE LORAN (LPC LADC)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:LORAN
Last Name:GILBERT
Suffix:
Gender:M
Credentials:LPC LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N 28TH ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-4900
Mailing Address - Country:US
Mailing Address - Phone:918-355-3729
Mailing Address - Fax:
Practice Address - Street 1:102 N ELM PL
Practice Address - Street 2:SUITE C
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-3883
Practice Address - Country:US
Practice Address - Phone:918-258-4487
Practice Address - Fax:918-259-0221
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1436101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health