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General NPI Number Information
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NPI Number | 1265891899
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Entity Type | Organization
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Legal Business Name | COUNSELING OFFICES OF RANDY L. CROWNOVER, LMFT, LLC
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Dates
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Enumeration Date | 02/10/2016
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Last Update Date | 02/10/2016
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Provider Practice Location Address
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Address Line | 501 E 15TH ST SUITE 500A
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City | EDMOND
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State | OK
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Zip | 73013-5043
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Country | US
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Telephone | 405-819-1349
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Fax | 866-551-2284
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Provider Business Mailing Address
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Address Line | 4733 FIRST LIGHT LN
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City | EDMOND
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State | OK
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Zip | 73034-0819
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Country | US
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Telephone | 404-819-1349
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Fax | 866-351-2284
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MR. RANDY CROWNOVER
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Credential | LMFT
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Telephone | 405-819-1349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 911
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License Number State | OK
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