Provider Demographics
NPI:1952828295
Name:WORSTER, STORMY C (LPC)
Entity Type:Individual
Prefix:
First Name:STORMY
Middle Name:C
Last Name:WORSTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 SUMMIT TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-7195
Mailing Address - Country:US
Mailing Address - Phone:405-301-7610
Mailing Address - Fax:405-364-5379
Practice Address - Street 1:2500 MCGEE DR STE 120
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-6705
Practice Address - Country:US
Practice Address - Phone:405-301-7610
Practice Address - Fax:405-364-5379
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-28
Last Update Date:2017-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5149101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional