Healthcare Provider Details

I. General information

NPI: 1992255475
Provider Name (Legal Business Name): CHANTRELL FIELDS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2016
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

941 W I 35 FRONTAGE RD STE 116
EDMOND OK
73034-7375
US

IV. Provider business mailing address

941 W I 35 FRONTAGE RD STE 116
EDMOND OK
73034-7375
US

V. Phone/Fax

Practice location:
  • Phone: 405-747-6065
  • Fax:
Mailing address:
  • Phone: 405-747-6065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberJ083576630
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: