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NPI Code Detail

MEDICARE: CRYSTAL ROSE HOFFMAN FAULKENBERRY LPC

MEDICARE: CRYSTAL ROSE HOFFMAN FAULKENBERRY LPC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1942557335
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL ROSE HOFFMAN FAULKENBERRY LPC
Provider Business Mailing Address
First Line : 4300 S HARVARD
Second Line : SUITE 100
City : TULSA
State : OK
Zip : 74135-2608
Country : US
Telephone Number : 918-585-3163
Fax Number : 918-584-1835
Provider Business Practice Location Address
First Line : 6216 S LEWIS AVE STE 180
Second Line :
City : TULSA
State : OK
Zip : 74136-1077
Country : US
Telephone Number : 918-960-7852
Fax Number : 539-664-5738
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2012
Last Update Date : 03/21/2024

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Directions to “ CRYSTAL ROSE HOFFMAN FAULKENBERRY LPC” Practice Location

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