TERI LEANN BOURDEAU (NPI# 1811051238) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811051238 |
| Entity Type | Individual |
| Full Name | TERI LEANN BOURDEAU |
| Credential | PH.D. |
| Practice Address |
2345 Southwest Blvd Tulsa OK 74107-2705 |
| Practice Telephone | 9185618383 |
| Practice Fax Number | 9185618546 |
| Mailing Telephone | 9185618383 |
| Mailing Fax Number | 9185618546 |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2014-02-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1009 | OK | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200078120A | 05 |
| Street Address |
2345 SOUTHWEST BLVD |
| City | TULSA |
| State | OK |
| Zip Code | 74107-2705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164403986 | Lana Dawn Myers | Family Medicine | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2005-11-09 |
| 1164040879 | Osu Center for Health Sciences | Clinic/Center | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-07-09 |
| 1962031591 | Dylan Tyler Roberts | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-06 |
| 1265061733 | Emil Amar Kasmia | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-06 |
| 1538798178 | Cody Hume Miller | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-06 |
| 1689203580 | Josiah Thomas Greer | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-03 |
| 1437788452 | Brandon Edward Rawlinson | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-02 |
| 1073142022 | Nicole L Abel | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-02 |
| 1952939183 | Tyler D Ingersoll | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-01 |
| 1144858358 | Christopher Jason Guinn | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd, Tulsa, OK 74107-2705 | 2020-04-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508493784 | Squareone Compassion Inc | Clinic/Center | 5323 South 65th West Avenue, Tulsa, OK 74107 | 2020-03-26 |
| 1649772476 | Lauren Michele Rogers | Student in an Organized Health Care Education/Training Program | 1111 W. 17th St., Barson 241, Tulsa, OK 74107 | 2018-03-07 |
| 1336641828 | Frank Patrick Goodman | Student in an Organized Health Care Education/Training Program | 2345 Sw Blvd, Tulsa, OK 74107 | 2018-03-01 |
| 1659827269 | Careatc - America Waste | Clinic/Center | 23322 Southwest Blvd, Tulsa, OK 74107 | 2016-09-01 |
| 1538530886 | Jeremy Michael Bowles | Pharmacist | 4227 Southwest Boulevard, Tulsa, OK 74107 | 2015-10-13 |
| 1760725865 | Nicholas Alexander | Student in an Organized Health Care Education/Training Program | 2345 Southwest Blvd., Osu Health Care Center, Tulsa, OK 74107 | 2013-03-27 |
| 1295095321 | Robert Steven Wedding | Counselor | 6033 S. 31 St. West Ave., Tulsa, OK 74107 | 2012-05-23 |
| 1295911451 | American Current Care P.a. | Clinic/Center | 5682 W Skelly Drive, Tulsa, OK 74107 | 2008-01-17 |
| 1821200072 | Leeca Jenkins | Counselor | 2007 W. 57th St, Tulsa, OK 74107 | 2007-05-03 |
| 1477670552 | Occupational Health Centers of The Southwest, P.a. | Clinic/Center | 5682 W. Skelly Drive, Tulsa, OK 74107 | 2007-03-23 |
| Find all providers in zip 74107 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255979340 | Tulsa Children's Development Center | Psychologist | 6931 S 66th East Ave Ste 200, Tulsa, OK 74133-1765 | 2019-12-19 |
| 1770084600 | Lisa Cromer | Psychologist | 8810 S Yale Ave Ste J, Tulsa, OK 74137-3551 | 2018-02-26 |
| 1124557426 | State of Oklahoma - Osu Center for Health Science College of Osteopath | Psychologist | 2488 E 81st St Ste 3700, Tulsa, OK 74137-4290 | 2017-06-08 |
| 1518339829 | Nathan Brusich | Psychologist | 5230 E 69th Pl, Tulsa, OK 74136-3407 | 2015-10-26 |
| 1649530023 | Namik Kirlic | Psychologist | 1304 W Easton St, Tulsa, OK 74127-6903 | 2012-05-21 |
| 1336448455 | Victoria Leigh Tracy | Psychologist | 7146 S Braden Ave Ste 700, Tulsa, OK 74136-6335 | 2011-03-16 |
| 1598061780 | Diane Constance Kirk | Psychologist | 3010 S Harvard Avenue, Suite 110, Tulsa, OK 74114-6124 | 2011-02-04 |
| 1841509197 | Victoria Lee Mccoy | Psychologist | 6655 S. Yale A, Laureate Psychiatric Clinic and Hospital, Tulsa, OK 74136 | 2010-10-05 |
| 1023295672 | John Stewart II | Psychologist | 5100 E Skelly Dr Ste 130, Tulsa, OK 74135 | 2008-01-25 |
| 1952506727 | Horace Wade Bedwell | Psychologist | 7945 S Lakewood Ave, Tulsa, OK 74136-9106 | 2007-06-20 |
| Find all providers in TULSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.