Provider Demographics
NPI:1942455241
Name:AUSTIN, MONICA ELAINE (LMFT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:ELAINE
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4607 HERITAGE PLACE DR APT 703
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-4335
Mailing Address - Country:US
Mailing Address - Phone:405-639-4714
Mailing Address - Fax:405-608-1171
Practice Address - Street 1:10404 VINEYARD BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-3705
Practice Address - Country:US
Practice Address - Phone:405-639-4714
Practice Address - Fax:405-608-1173
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK996106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist