Healthcare Provider Details

I. General information

NPI: 1962993162
Provider Name (Legal Business Name): KRYSTAL JANE LAWSON MA, MCP, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 W COVELL RD STE 100
EDMOND OK
73003-2381
US

IV. Provider business mailing address

755 W COVELL RD STE 100
EDMOND OK
73003-2381
US

V. Phone/Fax

Practice location:
  • Phone: 405-378-2727
  • Fax:
Mailing address:
  • Phone: 405-378-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10863
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10863
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: