Provider Demographics
NPI:1134741234
Name:PINKSTON, MARCIA LYNN (LPC, CANDIDATE)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:LYNN
Last Name:PINKSTON
Suffix:
Gender:F
Credentials:LPC, CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 N 240 RD
Mailing Address - Street 2:
Mailing Address - City:BEGGS
Mailing Address - State:OK
Mailing Address - Zip Code:74421-3162
Mailing Address - Country:US
Mailing Address - Phone:918-752-7377
Mailing Address - Fax:
Practice Address - Street 1:3445 S SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-1105
Practice Address - Country:US
Practice Address - Phone:918-610-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101Y00000X
OK101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional