Provider Demographics
NPI:1164060992
Name:INNOVO COUNSELING AND CONSULTING, INC.
Entity Type:Organization
Organization Name:INNOVO COUNSELING AND CONSULTING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DUFEK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-371-9271
Mailing Address - Street 1:10601 S WESTERN AVE STE 117
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-6215
Mailing Address - Country:US
Mailing Address - Phone:405-276-2476
Mailing Address - Fax:405-703-4429
Practice Address - Street 1:10601 S WESTERN AVE STE 117
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-6215
Practice Address - Country:US
Practice Address - Phone:405-276-2476
Practice Address - Fax:405-703-4429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty