Provider Demographics
NPI:1144520107
Name:STOUFFER, LAUREL (LPC)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:STOUFFER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LAUREL
Other - Middle Name:
Other - Last Name:DENNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12906 E 106TH ST N
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-5909
Mailing Address - Country:US
Mailing Address - Phone:918-214-3804
Mailing Address - Fax:918-376-4586
Practice Address - Street 1:12906 E 106TH ST N
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-5909
Practice Address - Country:US
Practice Address - Phone:918-214-3804
Practice Address - Fax:918-376-4586
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4934101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional