Healthcare Provider Details

I. General information

NPI: 1891069852
Provider Name (Legal Business Name): EDMOND CHILD AND FAMILY GUIDANCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2012
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 SOUTH FRETZ AVENUE
EDMOND OK
73003
US

IV. Provider business mailing address

1425 SOUTH FRETZ AVENUE
EDMOND OK
73003
US

V. Phone/Fax

Practice location:
  • Phone: 405-341-8894
  • Fax:
Mailing address:
  • Phone: 405-341-8894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. CAROL LEE PAPIN
Title or Position: OWNER
Credential: LPC
Phone: 405-341-8895