Provider Demographics
NPI:1831496389
Name:RAUPE, LANA ELAINE (MED, LPC)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:ELAINE
Last Name:RAUPE
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6051 N BROOKLINE AVE STE 125
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4286
Mailing Address - Country:US
Mailing Address - Phone:405-820-8885
Mailing Address - Fax:405-286-9588
Practice Address - Street 1:6051 N BROOKLINE AVE STE 125
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4286
Practice Address - Country:US
Practice Address - Phone:405-820-8885
Practice Address - Fax:405-286-9588
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-18
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4960101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200392670BMedicaid