Healthcare Provider Details

I. General information

NPI: 1265758874
Provider Name (Legal Business Name): TOTAL LIFE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2010
Last Update Date: 04/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 UNITED FOUNDERS BLVD SUITE 239
OKLAHOMA CITY OK
73112-3958
US

IV. Provider business mailing address

3000 UNITED FOUNDERS BLVD SUITE 239
OKLAHOMA CITY OK
73112-3958
US

V. Phone/Fax

Practice location:
  • Phone: 405-840-7040
  • Fax: 405-840-7012
Mailing address:
  • Phone: 405-840-7040
  • Fax: 405-840-7012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHARLOTTE CAMPBELL
Title or Position: EXECUTIVE DIRECTOR
Credential: ICADC
Phone: 405-840-7040