Provider Demographics
NPI:1467966952
Name:DANCING HAWK COUNSELING, LLC
Entity Type:Organization
Organization Name:DANCING HAWK COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCKUNE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, LADC
Authorized Official - Phone:580-379-4900
Mailing Address - Street 1:512 QUAIL RUN N
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-9723
Mailing Address - Country:US
Mailing Address - Phone:580-379-4900
Mailing Address - Fax:580-379-4921
Practice Address - Street 1:118 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-3816
Practice Address - Country:US
Practice Address - Phone:580-379-4900
Practice Address - Fax:580-379-4921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2729101YM0800X
OK129261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty