Provider Demographics
NPI:1114014834
Name:HOWARD-BIRKENMAIER, CAROLYN KAY (LPC, LBP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:KAY
Last Name:HOWARD-BIRKENMAIER
Suffix:
Gender:F
Credentials:LPC, LBP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N FINANCIAL TER STE G
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-4432
Mailing Address - Country:US
Mailing Address - Phone:405-256-5996
Mailing Address - Fax:405-265-2553
Practice Address - Street 1:110 S 5TH ST STE 200
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-2601
Practice Address - Country:US
Practice Address - Phone:405-256-5996
Practice Address - Fax:405-265-2553
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1659101Y00000X, 101YP2500X
OK0150101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health