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NPI Code Detail

MEDICARE: ANGELA LACYNDA PHILLIPS

MEDICARE: ANGELA LACYNDA PHILLIPS
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
1101Y00000XCounselor6747OK
2101Y00000XCounselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11316319510OTHEROKINDIVIDUAL NPI
2134602OTHEROKEAST CENTRAL UNIVERSITY
36747OTHEROKLPC LICENSED

General Provider Information

NPI Number : 1316319510
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA LACYNDA PHILLIPS
Provider Business Mailing Address
First Line : PO BOX 589
Second Line :
City : TECUMSEH
State : OK
Zip : 74873-0589
Country : US
Telephone Number : 405-296-3334
Fax Number :
Provider Business Practice Location Address
First Line : 602 N BROADWAY ST
Second Line :
City : TECUMSEH
State : OK
Zip : 74873-2020
Country : US
Telephone Number : 405-585-3833
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2015
Last Update Date : 03/17/2026

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Directions to “ ANGELA LACYNDA PHILLIPS ” Practice Location

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