1134216427 NPI number — LIFEFOCUS COUNSELING SERVICES

Table of content: (NPI 1134216427)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134216427 NPI number — LIFEFOCUS COUNSELING SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIFEFOCUS COUNSELING SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134216427
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/14/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4045 NW 64TH ST
Provider Second Line Business Mailing Address:
SUITE 501
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73116-1684
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-840-5252
Provider Business Mailing Address Fax Number:
405-840-1256

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4045 NW 64TH ST
Provider Second Line Business Practice Location Address:
SUITE 501
Provider Business Practice Location Address City Name:
OKLAHOMA CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73116-1684
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-840-5252
Provider Business Practice Location Address Fax Number:
405-840-1256
Provider Enumeration Date:
10/06/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BARNES
Authorized Official First Name:
WENONA
Authorized Official Middle Name:
RAY
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
405-840-5252

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  13 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YP1600X , with the licence number: 95-249 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)