Healthcare Provider Details

I. General information

NPI: 1336765189
Provider Name (Legal Business Name): CALYE MORGAN BOWEN LPC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CALYE MORGAN BOWEN LPC-C

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date: 02/10/2021
Reactivation Date: 02/05/2025

III. Provider practice location address

2524 N BROADWAY STE 327
EDMOND OK
73034-4177
US

IV. Provider business mailing address

2524 N BROADWAY STE 327
EDMOND OK
73034-4177
US

V. Phone/Fax

Practice location:
  • Phone: 405-548-5622
  • Fax:
Mailing address:
  • Phone: 405-548-5622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10888
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: