Provider Demographics
NPI:1003331075
Name:ODEN COUNSELING, PLLC
Entity Type:Organization
Organization Name:ODEN COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMILA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ODEN
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:405-412-1005
Mailing Address - Street 1:6600 NW 116TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-2937
Mailing Address - Country:US
Mailing Address - Phone:405-412-1005
Mailing Address - Fax:
Practice Address - Street 1:3033 NW 63RD ST STE 151E
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-3634
Practice Address - Country:US
Practice Address - Phone:405-412-1005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-10
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5285101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty