Provider Demographics
NPI:1578024121
Name:MILLIGAN, IAN WALKER (LMHC, LPC)
Entity Type:Individual
Prefix:
First Name:IAN
Middle Name:WALKER
Last Name:MILLIGAN
Suffix:
Gender:M
Credentials:LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 NW 33RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-8644
Mailing Address - Country:US
Mailing Address - Phone:405-830-2635
Mailing Address - Fax:
Practice Address - Street 1:409 NW 33RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-8644
Practice Address - Country:US
Practice Address - Phone:405-830-2635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008180-01101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor