Provider Demographics
NPI:1114497153
Name:CHRISTIAN CLINIC FOR COUNSELING OF EDMOND'S FIRST BAPTIST CHURCH, INC.
Entity Type:Organization
Organization Name:CHRISTIAN CLINIC FOR COUNSELING OF EDMOND'S FIRST BAPTIST CHURCH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIATT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:405-942-8888
Mailing Address - Street 1:1300 E 33RD ST # B1
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-6305
Mailing Address - Country:US
Mailing Address - Phone:405-942-8888
Mailing Address - Fax:405-407-2012
Practice Address - Street 1:1300 E 33RD ST # B1
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-6305
Practice Address - Country:US
Practice Address - Phone:405-942-8888
Practice Address - Fax:405-407-2012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-03
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty