Provider Demographics
NPI:1073957619
Name:INTEGRITY COUNSELING & CONSULTING SERVICES LLC
Entity Type:Organization
Organization Name:INTEGRITY COUNSELING & CONSULTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COUNSELING
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:S
Authorized Official - Last Name:NORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-513-6340
Mailing Address - Street 1:1601 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 10
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6359
Mailing Address - Country:US
Mailing Address - Phone:405-513-6340
Mailing Address - Fax:405-726-8985
Practice Address - Street 1:1601 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 10
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6359
Practice Address - Country:US
Practice Address - Phone:405-513-6340
Practice Address - Fax:405-513-6340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-25
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4561101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK4561OtherLICENSED PROFESSIONAL COUNSELOR
OK200481060AMedicaid