Provider Demographics
NPI:1134876881
Name:ERICA BLACK-HOOKS, M.A, LPC, PLLC
Entity type:Organization
Organization Name:ERICA BLACK-HOOKS, M.A, LPC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACK-HOOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-205-3236
Mailing Address - Street 1:11804 VAIL DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-1646
Mailing Address - Country:US
Mailing Address - Phone:405-205-3236
Mailing Address - Fax:
Practice Address - Street 1:11804 VAIL DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-1646
Practice Address - Country:US
Practice Address - Phone:405-205-3236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1659660827Medicaid