Provider Demographics
NPI:1023195344
Name:HARJO, RACHELLE DEANNE (LPCC, LPC,LADC/MH,RN)
Entity Type:Individual
Prefix:MRS
First Name:RACHELLE
Middle Name:DEANNE
Last Name:HARJO
Suffix:
Gender:F
Credentials:LPCC, LPC,LADC/MH,RN
Other - Prefix:
Other - First Name:RACHELLE
Other - Middle Name:DEANNE
Other - Last Name:DOBEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC,LPC
Mailing Address - Street 1:7250 FALCON RDG
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-9068
Mailing Address - Country:US
Mailing Address - Phone:405-315-4990
Mailing Address - Fax:
Practice Address - Street 1:4900 RICHMOND SQ STE 107
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-2043
Practice Address - Country:US
Practice Address - Phone:405-315-4990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2019-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6814101YM0800X
NM0073851101YM0800X
OK118884163W00000X
NM90266163W00000X
OK948101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163W00000XNursing Service ProvidersRegistered Nurse