Provider Demographics
NPI:1730967589
Name:CLOVERLEAF SERVICES PLLC
Entity type:Organization
Organization Name:CLOVERLEAF SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:580-465-0566
Mailing Address - Street 1:1356 N CHEYENNE AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74106-4624
Mailing Address - Country:US
Mailing Address - Phone:580-465-0566
Mailing Address - Fax:
Practice Address - Street 1:1401 N CHEYENNE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-4625
Practice Address - Country:US
Practice Address - Phone:580-465-0566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty