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General NPI Number Information
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NPI Number | 1104909332
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Entity Type | Organization
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Legal Business Name | CENTER FOR POSITIVE CHANGE, INC.
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 1607 PROFESSIONAL CIR
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City | YUKON
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State | OK
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Zip | 73099-6314
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Country | US
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Telephone | 405-354-7779
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Fax | 405-265-2553
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Provider Business Mailing Address
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Address Line | 500 N FINANCIAL TER STE G
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City | MUSTANG
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State | OK
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Zip | 73064-4432
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Country | US
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Telephone | 52-565-9964
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Fax | 405-265-2553
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Authorized Official
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Title or Position | OWNER
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Name | CAROLYN KAY HOWARD-BIRKENMAIER
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Credential | LPC
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Telephone | 405-256-5996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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