Provider Demographics
NPI:1982745410
Name:BIEBER, GLENDA GAIL (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:GLENDA
Middle Name:GAIL
Last Name:BIEBER
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 1:307 WATERFORD ST
Mailing Address - Street 2:
Mailing Address - City:CATOOSA
Mailing Address - State:OK
Mailing Address - Zip Code:74015-5990
Mailing Address - Country:US
Mailing Address - Phone:865-388-7673
Mailing Address - Fax:
Practice Address - Street 1:2021 S LEWIS AVE STE 325
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5719
Practice Address - Country:US
Practice Address - Phone:918-281-5031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0045751041C0700X
OK11941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4111345OtherBCBS
TN3989517Medicaid
TN3989517Medicare ID - Type Unspecified