Provider Demographics
NPI:1922244078
Name:ELDERCOUNSELING AND CLINICAL SERVICES PLLC
Entity Type:Organization
Organization Name:ELDERCOUNSELING AND CLINICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREL
Authorized Official - Middle Name:A
Authorized Official - Last Name:DINKEL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:405-809-4222
Mailing Address - Street 1:717 GYRFALCON DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-8157
Mailing Address - Country:US
Mailing Address - Phone:405-809-4222
Mailing Address - Fax:405-364-5379
Practice Address - Street 1:717 GYRFALCON DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-8157
Practice Address - Country:US
Practice Address - Phone:405-809-4222
Practice Address - Fax:405-364-5379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty