Healthcare Provider Details

I. General information

NPI: 1306459193
Provider Name (Legal Business Name): KRISTEN ANDERSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2020
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 N BROOKLINE AVE STE 350
OKLAHOMA CITY OK
73112-3603
US

IV. Provider business mailing address

5100 N BROOKLINE AVE STE 350
OKLAHOMA CITY OK
73112-3603
US

V. Phone/Fax

Practice location:
  • Phone: 405-568-1440
  • Fax:
Mailing address:
  • Phone: 405-568-1440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10815
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: