MEDICARE: LANDOLFI COUNSELING SERVICES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	4401	OK

General Provider Information

NPI Number	:	1801101837
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANDOLFI COUNSELING SERVICES, PLLC

Provider Business Mailing Address
First Line	:	4200 PERIMETER CENTER DR
Second Line	:	SUITE 245
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2324
Country	:	US
Telephone Number	:	405-947-7554
Fax Number	:	405-947-7607

Provider Business Practice Location Address
First Line	:	4200 PERIMETER CENTER DR
Second Line	:	SUITE 245
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2324
Country	:	US
Telephone Number	:	405-947-7554
Fax Number	:	405-947-7607

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	MRS. KAREN ALICE LANDOLFI
Credential	:	LPC
Telephone Number	:	405-947-7554

Provider Enumeration Date	:	08/13/2010
Last Update Date	:	08/13/2010

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