Provider Demographics
NPI:1417982794
Name:CAWLFIELD, JOHNNY R (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:JOHNNY
Middle Name:R
Last Name:CAWLFIELD
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 N MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-8829
Mailing Address - Country:US
Mailing Address - Phone:405-624-1776
Mailing Address - Fax:405-372-7349
Practice Address - Street 1:5525 E 51ST ST
Practice Address - Street 2:SUITE #400
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-7461
Practice Address - Country:US
Practice Address - Phone:918-388-6204
Practice Address - Fax:918-388-6456
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK848106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist