Provider Demographics
NPI:1275834905
Name:MAYFIELD, DONNA KAY (LPC CANDIDATE)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:KAY
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:LPC CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5521 TEXOMA DR
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-5935
Mailing Address - Country:US
Mailing Address - Phone:580-278-4067
Mailing Address - Fax:
Practice Address - Street 1:5521 TEXOMA DR
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-5935
Practice Address - Country:US
Practice Address - Phone:580-278-4067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-11
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6705101Y00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200373900BMedicaid