=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235345638
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BELINDA G CROSIER LPC, LADC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1251 N BROADWAY STE C
-----------------------------------------------------
City | EDMOND
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73034-3616
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-341-3554
-----------------------------------------------------
Fax | 405-341-3511
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1251 N BROADWAY STE C
-----------------------------------------------------
City | EDMOND
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73034-3616
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-341-3554
-----------------------------------------------------
Fax | 405-341-3511
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | #573
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------