Healthcare Provider Details

I. General information

NPI: 1689601759
Provider Name (Legal Business Name): RANDY L HENDRIX LPC,LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 08/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 MARSHALL AVE
NORMAN OK
73072-8022
US

IV. Provider business mailing address

3280 MARSHALL AVE
NORMAN OK
73072-8022
US

V. Phone/Fax

Practice location:
  • Phone: 405-579-5858
  • Fax: 405-292-1787
Mailing address:
  • Phone: 405-579-5858
  • Fax: 405-292-1787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number751
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number407
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: