Provider Demographics
NPI:1972151975
Name:HOUPE, JILL YVONNE (LPC)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:YVONNE
Last Name:HOUPE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 E 171ST ST N
Mailing Address - Street 2:
Mailing Address - City:SKIATOOK
Mailing Address - State:OK
Mailing Address - Zip Code:74070-3390
Mailing Address - Country:US
Mailing Address - Phone:918-798-0285
Mailing Address - Fax:
Practice Address - Street 1:2004 E 171ST ST N
Practice Address - Street 2:
Practice Address - City:SKIATOOK
Practice Address - State:OK
Practice Address - Zip Code:74070-3390
Practice Address - Country:US
Practice Address - Phone:918-798-0285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2789101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional