Provider Demographics
NPI:1497368245
Name:CHRISTINA CONRAD, LPC, PLLC
Entity Type:Organization
Organization Name:CHRISTINA CONRAD, LPC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE AND CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRSITINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CONRAD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, SEP
Authorized Official - Phone:918-694-6606
Mailing Address - Street 1:5327 S SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-7521
Mailing Address - Country:US
Mailing Address - Phone:918-694-6606
Mailing Address - Fax:
Practice Address - Street 1:5327 S SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-7521
Practice Address - Country:US
Practice Address - Phone:918-694-6606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-30
Last Update Date:2020-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty