Provider Demographics
NPI:1467655381
Name:HUCKS, CASEY JON (LPC)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:JON
Last Name:HUCKS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E MAIN
Mailing Address - Street 2:RESOURCE MANAGEMENT
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820
Mailing Address - Country:US
Mailing Address - Phone:580-436-7211
Mailing Address - Fax:580-272-5757
Practice Address - Street 1:777 CASINO AVE
Practice Address - Street 2:BENEFITS DEPT
Practice Address - City:THACKERVILLE
Practice Address - State:OK
Practice Address - Zip Code:73459
Practice Address - Country:US
Practice Address - Phone:580-272-5170
Practice Address - Fax:580-421-8772
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2265101YP2500X
OK2268101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional