Provider Demographics
NPI:1114700929
Name:ELVIK, AUGUSTA ANNE (LPC)
Entity Type:Individual
Prefix:
First Name:AUGUSTA
Middle Name:ANNE
Last Name:ELVIK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16800 TRIANA DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-6702
Mailing Address - Country:US
Mailing Address - Phone:405-996-8588
Mailing Address - Fax:
Practice Address - Street 1:1008 24TH AVE NW
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6369
Practice Address - Country:US
Practice Address - Phone:405-310-3262
Practice Address - Fax:405-876-6364
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10614101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional