Provider Demographics
NPI:1821591983
Name:FOLSOM, COURTNEY MICHELE (LPC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MICHELE
Last Name:FOLSOM
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 1:501 SE 4TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-6790
Mailing Address - Country:US
Mailing Address - Phone:405-256-2071
Mailing Address - Fax:
Practice Address - Street 1:501 SE 4TH ST STE C
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-6790
Practice Address - Country:US
Practice Address - Phone:405-256-2071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-15
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7482101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health