Healthcare Provider Details

I. General information

NPI: 1063963379
Provider Name (Legal Business Name): NOLAN CHOJNACKI LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2016
Last Update Date: 01/16/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 CIRCLE ST
TAHLEQUAH OK
74464-2600
US

IV. Provider business mailing address

506 CIRCLE ST
TAHLEQUAH OK
74464-2600
US

V. Phone/Fax

Practice location:
  • Phone: 918-506-3401
  • Fax:
Mailing address:
  • Phone: 918-506-3401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC07151
License Number StateOK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: