Provider Demographics
NPI:1083783195
Name:FOSSEY, BENAY (LMFT)
Entity Type:Individual
Prefix:MS
First Name:BENAY
Middle Name:
Last Name:FOSSEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:BENAY
Other - Middle Name:
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1704 NW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-3808
Mailing Address - Country:US
Mailing Address - Phone:405-795-3597
Mailing Address - Fax:
Practice Address - Street 1:1704 NW 21ST ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-3808
Practice Address - Country:US
Practice Address - Phone:405-795-3597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor