Provider Demographics
NPI:1437379286
Name:FRIESEN, JEAN M (LPC)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:M
Last Name:FRIESEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:M
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBS
Mailing Address - Street 1:812 SE 36TH ST
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-7729
Mailing Address - Country:US
Mailing Address - Phone:405-799-9120
Mailing Address - Fax:
Practice Address - Street 1:909 ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5229
Practice Address - Country:US
Practice Address - Phone:405-573-6498
Practice Address - Fax:405-573-3958
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health