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General NPI Number Information
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NPI Number | 1437651908
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Entity Type | Organization
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Legal Business Name | FAITH OVER FEAR COUNSELING LLC
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 03/01/2018
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Provider Practice Location Address
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Address Line | 1909 MAIN ST
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City | WOODWARD
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State | OK
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Zip | 73801-2942
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Country | US
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Telephone | 580-334-6167
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Fax |
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Provider Business Mailing Address
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Address Line | 501 EDGEWATER DR
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City | WOODWARD
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State | OK
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Zip | 73801-6903
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Country | US
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Telephone | 580-334-6167
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | COURTNEY RENEE LAWELLIN
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Credential | LADC/MH
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Telephone | 580-334-6167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 987
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 987
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 987
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License Number State | OK
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