Healthcare Provider Details

I. General information

NPI: 1013789940
Provider Name (Legal Business Name): ELIZABETH N EDLING LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 N SHARTEL AVE STE 409
OKLAHOMA CITY OK
73103-2444
US

IV. Provider business mailing address

1211 N SHARTEL AVE STE 409
OKLAHOMA CITY OK
73103-2444
US

V. Phone/Fax

Practice location:
  • Phone: 405-458-8628
  • Fax:
Mailing address:
  • Phone: 405-458-8628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11854
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: