=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750170866
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TORKLESON COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/05/2025
-----------------------------------------------------
Last Update Date | 05/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23484 E 136TH ST S
-----------------------------------------------------
City | COWETA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74429-6757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-859-5876
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23484 E 136TH ST S
-----------------------------------------------------
City | COWETA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74429-6757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-859-5876
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | LAUREN TORKLESON
-----------------------------------------------------
Credential | LPC-S
-----------------------------------------------------
Telephone | 918-859-5876
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------