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NPI Code Detail

MEDICARE: CRYSTAL ANNETTE ROARK LPC

MEDICARE: CRYSTAL ANNETTE ROARK LPC
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 Counselor
2101YP2500XProfessional CounselorLPC06280OK

General Provider Information

NPI Number : 1225040553
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL ANNETTE ROARK LPC
Provider Business Mailing Address
First Line : 909 ALAMEDA ST
Second Line :
City : NORMAN
State : OK
Zip : 73071-5229
Country : US
Telephone Number : 405-360-5100
Fax Number :
Provider Business Practice Location Address
First Line : 909 ALAMEDA ST
Second Line :
City : NORMAN
State : OK
Zip : 73071-5229
Country : US
Telephone Number : 405-360-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2006
Last Update Date : 09/16/2024

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Directions to “ CRYSTAL ANNETTE ROARK LPC” Practice Location

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