Provider Demographics
NPI:1255710984
Name:LEDFORD, STEPHANIE ELAINE
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ELAINE
Last Name:LEDFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5512 S IRVINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-7525
Mailing Address - Country:US
Mailing Address - Phone:918-809-1712
Mailing Address - Fax:
Practice Address - Street 1:1616 N GILCREASE MUSEUM RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-2101
Practice Address - Country:US
Practice Address - Phone:405-426-5070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)