Provider Demographics
NPI:1194471896
Name:HOLASEK, BAILEY (NCC, LPC-CANDIDATE)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:HOLASEK
Suffix:
Gender:F
Credentials:NCC, LPC-CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10850 BOX RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:OK
Mailing Address - Zip Code:73051-6705
Mailing Address - Country:US
Mailing Address - Phone:918-704-2175
Mailing Address - Fax:
Practice Address - Street 1:210 S COCKREL AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5610
Practice Address - Country:US
Practice Address - Phone:405-801-4998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLPCCANDIDATE10596101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor