Provider Demographics
NPI:1154497022
Name:MADDOX, LUCINDA DAWN (LPC)
Entity Type:Individual
Prefix:MS
First Name:LUCINDA
Middle Name:DAWN
Last Name:MADDOX
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:LUCINDA
Other - Middle Name:DAWN
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:7908 NW 23RD ST
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-4950
Mailing Address - Country:US
Mailing Address - Phone:405-440-1006
Mailing Address - Fax:405-440-1007
Practice Address - Street 1:7908 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-4950
Practice Address - Country:US
Practice Address - Phone:405-440-1006
Practice Address - Fax:405-440-1007
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2973101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional