Provider Demographics
NPI:1285832162
Name:WOODARD, CARLOS FERAND SR (LPC)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:FERAND
Last Name:WOODARD
Suffix:SR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7901 NE 10TH ST
Mailing Address - Street 2:C110
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-3600
Mailing Address - Country:US
Mailing Address - Phone:405-736-6454
Mailing Address - Fax:405-736-1507
Practice Address - Street 1:7901 NE 10TH ST
Practice Address - Street 2:C110
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-3600
Practice Address - Country:US
Practice Address - Phone:405-736-6454
Practice Address - Fax:405-736-1507
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3010101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional