1285989459 NPI number — SHERRY GOINES LOVING LPC

Table of content: SHERRY GOINES LOVING LPC (NPI 1285989459)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285989459 NPI number — SHERRY GOINES LOVING LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOINES LOVING
Provider First Name:
SHERRY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GOINES
Provider Other First Name:
SHERRY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1285989459
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/02/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 662
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PURCELL
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73080
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-527-1785
Provider Business Mailing Address Fax Number:
405-527-1084

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
221 N. WEWOKA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEWOKA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74884
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-257-9030
Provider Business Practice Location Address Fax Number:
405-257-9031
Provider Enumeration Date:
07/13/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101Y00000X , with the licence number: 7035 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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