Provider Demographics
NPI:1124129077
Name:LASHLEY, KAREN H (PHD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:H
Last Name:LASHLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4815 S HARVARD AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-3060
Mailing Address - Country:US
Mailing Address - Phone:918-567-1839
Mailing Address - Fax:918-512-4189
Practice Address - Street 1:4815 S HARVARD AVE STE 250
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3060
Practice Address - Country:US
Practice Address - Phone:918-567-1839
Practice Address - Fax:918-512-4189
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK586103T00000X, 103TC0700X, 103TC2200X, 103TP2701X, 103TC1900X
TNP2174103TC2200X, 103TP2701X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200021970BMedicaid
OK200021970AMedicaid