Provider Demographics
NPI:1306211925
Name:FAITH DYNAMIC COUNSELING LLC
Entity Type:Organization
Organization Name:FAITH DYNAMIC COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PASCAL
Authorized Official - Middle Name:B
Authorized Official - Last Name:LANGSI
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC
Authorized Official - Phone:405-532-6563
Mailing Address - Street 1:2405 W I 44 SERVICE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-8771
Mailing Address - Country:US
Mailing Address - Phone:405-532-6563
Mailing Address - Fax:
Practice Address - Street 1:2405 W I 44 SERVICE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8771
Practice Address - Country:US
Practice Address - Phone:405-532-6563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty