Provider Demographics
NPI:1013880228
Name:PAULA BONEBRAKE, LPC
Entity type:Organization
Organization Name:PAULA BONEBRAKE, LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BONEBRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC
Authorized Official - Phone:918-637-8373
Mailing Address - Street 1:12801 E 85TH ST N STE 101
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-2259
Mailing Address - Country:US
Mailing Address - Phone:918-637-8373
Mailing Address - Fax:918-856-3671
Practice Address - Street 1:12801 E 85TH ST N STE 101
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-2259
Practice Address - Country:US
Practice Address - Phone:918-637-8373
Practice Address - Fax:918-856-3671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty