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General NPI Number Information
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NPI Number | 1033976246
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Entity Type | Organization
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Legal Business Name | CHAOS COUNSELING LLC
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 2500 MCGEE DR STE 104
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City | NORMAN
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State | OK
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Zip | 73072-6705
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Country | US
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Telephone | 405-623-8733
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Fax |
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Provider Business Mailing Address
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Address Line | 200 MIDWAY DR
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City | NORMAN
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State | OK
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Zip | 73072-4321
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Country | US
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Telephone | 405-623-8733
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CASSANDRA BOURNIVAL
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Credential | LMFT
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Telephone | 405-623-8733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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