Provider Demographics
NPI:1861512097
Name:HUNTER, KEVIN VAUGHN (MHR, LPC)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:VAUGHN
Last Name:HUNTER
Suffix:
Gender:M
Credentials:MHR, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 NW 41ST ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-2402
Mailing Address - Country:US
Mailing Address - Phone:405-528-7652
Mailing Address - Fax:
Practice Address - Street 1:624 NW 5TH ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-3924
Practice Address - Country:US
Practice Address - Phone:405-799-3379
Practice Address - Fax:405-700-0912
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2345101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional