Letisha Lynn Stovall Leblanc, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

3763 Issued in OK

Practice address

418 E 2ND St
Okmulgee, OK 74447-3302

Phone

(918) 268-6444

Fax

(918) 518-7402

NPI assigned

Jun 20, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Letisha Lynn Stovall Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Okmulgee-Okfuskee County Youth Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Okmulgee, OK
  • NPI 1073634168
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1770879660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12860 GUN CLUB RD",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744478908",
            "telephone_number": "270-314-4486",
            "fax_number": "918-518-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 E 2ND ST",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744473302",
            "telephone_number": "918-268-6444",
            "fax_number": "918-518-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVALL LEBLANC",
        "first_name": "LETISHA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OK",
            "license": "3763",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LETISHA",
            "last_name": "STOVALL",
            "middle_name": "LYNN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• State of Oklahoma-Okmulgee
• Sarah Stice, FSP
• Jasmine Michelle Stidman, C-SLPA
• Jonathan Stolarski, C-SLPA
• Tyler Stone, LMSW
• Margaret Ann Stripling, D.O.
• Ricky Joe Sturman Jr.
• Evan Tansey
• Carmin Tecumseh, MHR
• Courtney Gaige Terrill, DPT

• Social Worker in Okmulgee, OK
• Providers in Okmulgee, OK by specialty
• Social Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.