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NPI Code Detail

MEDICARE: KENSLEY MERRY MA, LPC-S

MEDICARE: KENSLEY MERRY MA, LPC-S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorOK

General Provider Information

NPI Number : 1043710353
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENSLEY MERRY MA, LPC-S
Provider Business Mailing Address
First Line : 1300 E 15TH ST STE 130
Second Line :
City : EDMOND
State : OK
Zip : 73013-5051
Country : US
Telephone Number : 405-726-1555
Fax Number :
Provider Business Practice Location Address
First Line : 1300 E 15TH ST STE 130
Second Line :
City : EDMOND
State : OK
Zip : 73013-5051
Country : US
Telephone Number : 405-562-3535
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2018
Last Update Date : 07/22/2023

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Directions to “ KENSLEY MERRY MA, LPC-S” Practice Location

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