Provider Demographics
NPI:1437761004
Name:RUNNELLS, ASHLEY JANE (NCC, LPC-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:JANE
Last Name:RUNNELLS
Suffix:
Gender:F
Credentials:NCC, LPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4867 S SHERIDAN RD STE 712A
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-5721
Mailing Address - Country:US
Mailing Address - Phone:918-407-9803
Mailing Address - Fax:
Practice Address - Street 1:4867 S SHERIDAN RD STE 712A
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-5721
Practice Address - Country:US
Practice Address - Phone:918-407-9803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor