Healthcare Provider Details

I. General information

NPI: 1063643559
Provider Name (Legal Business Name): MICHELE LENA GRIFFIN M.ED. LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MICHELE LENA WARD M.ED. LPC

II. Dates (important events)

Enumeration Date: 07/31/2009
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4805 GREEN OAKS DR
RIVER OAKS TX
76114-3004
US

IV. Provider business mailing address

112 N. WITTE ST
POTEAU OK
74953
US

V. Phone/Fax

Practice location:
  • Phone: 817-624-1222
  • Fax: 817-460-0286
Mailing address:
  • Phone: 918-839-5561
  • Fax: 918-647-2926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4201
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number102599
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: