Provider Demographics
NPI:1780065433
Name:SUFFRIDGE, SUMMER (MSSA)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:
Last Name:SUFFRIDGE
Suffix:
Gender:F
Credentials:MSSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2613 N COUNCIL AVE
Mailing Address - Street 2:
Mailing Address - City:BLANCHARD
Mailing Address - State:OK
Mailing Address - Zip Code:73010-8027
Mailing Address - Country:US
Mailing Address - Phone:405-870-3084
Mailing Address - Fax:
Practice Address - Street 1:300 N MERIDIAN AVE
Practice Address - Street 2:SUITE 280-N
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-6560
Practice Address - Country:US
Practice Address - Phone:405-942-5570
Practice Address - Fax:405-942-5603
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK66111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical