Provider Demographics
NPI:1245778877
Name:MARRIAGE AND FAMILY SOLUTIONS, LLC
Entity Type:Organization
Organization Name:MARRIAGE AND FAMILY SOLUTIONS, LLC
Other - Org Name:CLAIRE DOMECK, M.A., LMFT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMECK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:918-313-1439
Mailing Address - Street 1:PO BOX 982
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-0982
Mailing Address - Country:US
Mailing Address - Phone:918-313-1439
Mailing Address - Fax:
Practice Address - Street 1:418 EAST B STREET
Practice Address - Street 2:SUITE A
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037
Practice Address - Country:US
Practice Address - Phone:918-313-1439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK811106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty