Healthcare Provider Details

I. General information

NPI: 1396221776
Provider Name (Legal Business Name): SONJA LYNN MORRELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2018
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 W BROADWAY ST STE 51A
ARDMORE OK
73401-2501
US

IV. Provider business mailing address

1301 KIOWA ST
ARDMORE OK
73401-2280
US

V. Phone/Fax

Practice location:
  • Phone: 580-226-9388
  • Fax: 580-226-9395
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7463
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: