Provider Demographics
NPI:1740593912
Name:KOUTNIK, MEGAN D (MS LPC NCC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:D
Last Name:KOUTNIK
Suffix:
Gender:F
Credentials:MS LPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 S HARVARD AVE
Mailing Address - Street 2:STE 207
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-3048
Mailing Address - Country:US
Mailing Address - Phone:918-748-9868
Mailing Address - Fax:918-748-9835
Practice Address - Street 1:4720 S HARVARD AVE
Practice Address - Street 2:STE 207
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3048
Practice Address - Country:US
Practice Address - Phone:918-748-9868
Practice Address - Fax:918-748-9835
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor