Provider Demographics
NPI:1598700452
Name:COMPTON-AMOS, BEVERLY JEAN (LPC)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:JEAN
Last Name:COMPTON-AMOS
Suffix:
Gender:F
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:PO BOX 5072
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-5072
Mailing Address - Country:US
Mailing Address - Phone:405-292-0220
Mailing Address - Fax:405-307-0294
Practice Address - Street 1:1637 STUBBEMAN AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-8661
Practice Address - Country:US
Practice Address - Phone:405-292-0220
Practice Address - Fax:405-307-0294
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1833101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional