Healthcare Provider Details

I. General information

NPI: 1134216427
Provider Name (Legal Business Name): LIFEFOCUS COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 NW 64TH ST SUITE 501
OKLAHOMA CITY OK
73116-1684
US

IV. Provider business mailing address

4045 NW 64TH ST SUITE 501
OKLAHOMA CITY OK
73116-1684
US

V. Phone/Fax

Practice location:
  • Phone: 405-840-5252
  • Fax: 405-840-1256
Mailing address:
  • Phone: 405-840-5252
  • Fax: 405-840-1256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number95-249
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number13
License Number StateOK

VIII. Authorized Official

Name: WENONA RAY BARNES
Title or Position: CEO
Credential: LADC, MHR, CEAP
Phone: 405-840-5252