Provider Demographics
NPI:1063855948
Name:CCC PSYCHOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:CCC PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIOCO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:405-326-4599
Mailing Address - Street 1:4811 GAILLARDIA PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-1874
Mailing Address - Country:US
Mailing Address - Phone:405-325-4599
Mailing Address - Fax:405-607-1178
Practice Address - Street 1:4811 GAILLARDIA PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-1874
Practice Address - Country:US
Practice Address - Phone:405-325-4599
Practice Address - Fax:405-607-1178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK668103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty