Provider Demographics
NPI:1649212093
Name:BURKES GILLES, SHARLOTTE RENEE (LPC)
Entity Type:Individual
Prefix:MS
First Name:SHARLOTTE
Middle Name:RENEE
Last Name:BURKES GILLES
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 1:49 TAYLOR TER
Mailing Address - Street 2:
Mailing Address - City:ALEX
Mailing Address - State:OK
Mailing Address - Zip Code:73002-2248
Mailing Address - Country:US
Mailing Address - Phone:405-756-7386
Mailing Address - Fax:
Practice Address - Street 1:109 WILLOW
Practice Address - Street 2:
Practice Address - City:PAULS VALLEY
Practice Address - State:OK
Practice Address - Zip Code:73075
Practice Address - Country:US
Practice Address - Phone:405-238-7311
Practice Address - Fax:405-238-3530
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2741101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional