Individual ProviderTeri L HausamSocial WorkerBehavioral Health & Social Service ProvidersPractice Address6655 S Yale Ave, Laureate Psychiatric Clinic And Hospital, Tulsa, OK 74136-3326(918) 481-4000(918) 488-6653PECOS EnrollmentBased on the most recent information from CMS, provider Teri L Hausam does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:47 AM.Profile DetailsProvider ID1356310676Provider TypeIndividualFull NameHausam, Teri LCredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date3/17/2006Last Updated10/11/2018Contact InformationPractice LocationPractice Address6655 S Yale Ave, Laureate Psychiatric Clinic And Hospital, Tulsa, OK 74136-3326Phone(918) 481-4000Fax(918) 491-5740Mailing LocationMailing Address6600 S Yale Ave, Ste 1200, Tulsa, OK 74136-3361Phone(918) 488-6653Fax(918) 488-6627Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense1453OklahomaProvider IdentifiersIDDescriptionIssuerID2019171DescriptionOtherIssuerCIGNA BEHAVIORAL HEALTH