Provider Demographics
NPI:1184166597
Name:COUNSELING COMPLIANCE & RESOLUTION SERVICES OF OKLAHOMA, LLC
Entity type:Organization
Organization Name:COUNSELING COMPLIANCE & RESOLUTION SERVICES OF OKLAHOMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DARCY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:LADC, LPC
Authorized Official - Phone:405-919-7388
Mailing Address - Street 1:2000 SONOMA PARK DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013
Mailing Address - Country:US
Mailing Address - Phone:405-285-5459
Mailing Address - Fax:
Practice Address - Street 1:2000 SONOMA PARK DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-2092
Practice Address - Country:US
Practice Address - Phone:405-285-5459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4633101Y00000X
OK896101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty