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General NPI Number Information
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NPI Number | 1053736264
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Entity Type | Individual
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Provider Name | DORIANNE BROOKE CROSBY LPC, LPCC
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Gender | Female
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Dates
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Enumeration Date | 02/25/2014
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 1019 WATERWOOD PKWY
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City | EDMOND
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State | OK
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Zip | 73034-5332
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Country | US
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Telephone | 405-740-0808
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27120
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City | SAN DIEGO
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State | CA
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Zip | 92198-1120
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Country | US
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Telephone | 405-740-0808
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 10978
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 5824
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License Number State | OK
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