Provider Demographics
NPI:1972186948
Name:MARK SHREFFLER LPC LLC
Entity Type:Organization
Organization Name:MARK SHREFFLER LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SHREFFLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-596-1893
Mailing Address - Street 1:10948 NW EXPRESSWAY STE 10
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-8787
Mailing Address - Country:US
Mailing Address - Phone:405-596-1893
Mailing Address - Fax:
Practice Address - Street 1:10948 NW EXPRESSWAY STE 10
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-8787
Practice Address - Country:US
Practice Address - Phone:405-596-1893
Practice Address - Fax:405-883-6051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty