Healthcare Provider Details

I. General information

NPI: 1942502430
Provider Name (Legal Business Name): JENNIFER GAYLE ALLEN MS, LPC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2010
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12617 S MCLOUD RD
MCLOUD OK
74851-8509
US

IV. Provider business mailing address

12617 S MCLOUD RD
MCLOUD OK
74851-8509
US

V. Phone/Fax

Practice location:
  • Phone: 405-986-0173
  • Fax:
Mailing address:
  • Phone: 405-986-0173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6136
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: