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General NPI Number Information
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NPI Number | 1346642154
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Entity Type | Organization
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Legal Business Name | CAROL A MATHISON, LPC & ASSOCIATES
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Dates
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Enumeration Date | 09/23/2014
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Last Update Date | 09/23/2014
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Provider Practice Location Address
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Address Line | 212 E 2ND ST
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City | EDMOND
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State | OK
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Zip | 73034-4560
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Country | US
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Telephone | 405-820-6231
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Fax |
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Provider Business Mailing Address
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Address Line | 212 E 2ND ST
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City | EDMOND
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State | OK
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Zip | 73034-4560
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Country | US
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Telephone | 405-820-6231
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAROL MATHISON
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Credential | LPC
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Telephone | 405-820-6231
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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 | 3315
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License Number State | OK
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