Provider Demographics
NPI:1992424238
Name:PIELSTICKER, PEYTON (LMSW)
Entity type:Individual
Prefix:
First Name:PEYTON
Middle Name:
Last Name:PIELSTICKER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 W 71ST ST S
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74131-3459
Mailing Address - Country:US
Mailing Address - Phone:918-934-4010
Mailing Address - Fax:
Practice Address - Street 1:4900 W OAK LEAF DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74131
Practice Address - Country:US
Practice Address - Phone:918-934-4010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50092-0322101YA0400X
OK21348104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)