Provider Demographics
NPI:1710127352
Name:CONOVER, JAIME NOELLE (MA LPC)
Entity Type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:NOELLE
Last Name:CONOVER
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5530 N WESTERN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-4014
Mailing Address - Country:US
Mailing Address - Phone:405-286-0545
Mailing Address - Fax:405-286-0545
Practice Address - Street 1:5530 N WESTERN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-4014
Practice Address - Country:US
Practice Address - Phone:405-286-0545
Practice Address - Fax:405-286-0545
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3738101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor