Healthcare Provider Details

I. General information

NPI: 1598585887
Provider Name (Legal Business Name): KARSYN TERRELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2024
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 99
THOMAS OK
73669-0099
US

IV. Provider business mailing address

PO BOX 99
THOMAS OK
73669-0099
US

V. Phone/Fax

Practice location:
  • Phone: 580-661-3488
  • Fax: 580-661-3487
Mailing address:
  • Phone: 580-661-3488
  • Fax: 580-661-3487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number475047832
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: