Provider Demographics
NPI:1497048375
Name:MCCOOK, RYANNE (MA, LPC CANDIDATE)
Entity Type:Individual
Prefix:
First Name:RYANNE
Middle Name:
Last Name:MCCOOK
Suffix:
Gender:F
Credentials:MA, LPC CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 E 66TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3701
Mailing Address - Country:US
Mailing Address - Phone:918-293-2530
Mailing Address - Fax:918-492-2074
Practice Address - Street 1:1013 E 66TH PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3701
Practice Address - Country:US
Practice Address - Phone:918-293-2530
Practice Address - Fax:918-492-2074
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health