Provider Demographics
NPI:1891077103
Name:ECKELS, KELCY (MA, LPC)
Entity Type:Individual
Prefix:
First Name:KELCY
Middle Name:
Last Name:ECKELS
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 1:5225 N SHARTEL AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-6064
Mailing Address - Country:US
Mailing Address - Phone:405-808-3987
Mailing Address - Fax:
Practice Address - Street 1:5225 N SHARTEL AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-6064
Practice Address - Country:US
Practice Address - Phone:405-808-3987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker