Provider Demographics
NPI:1023232006
Name:VETTER, ALBERT J (LPC)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:J
Last Name:VETTER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:AL
Other - Middle Name:J
Other - Last Name:VETTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:9042 E 67TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133
Mailing Address - Country:US
Mailing Address - Phone:918-250-4876
Mailing Address - Fax:918-508-2275
Practice Address - Street 1:4150 S 100TH EAST AVE
Practice Address - Street 2:SUITE 200V
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-3650
Practice Address - Country:US
Practice Address - Phone:918-508-2275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2330 LPC101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor